Provider Demographics
NPI:1487186847
Name:COMPREHENSIVE PAIN INC
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN INC
Other - Org Name:HEALTHY LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-431-2880
Mailing Address - Street 1:1466 BEACH AVE APT 12A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-3622
Mailing Address - Country:US
Mailing Address - Phone:347-431-2880
Mailing Address - Fax:347-281-7740
Practice Address - Street 1:1466 BEACH AVE APT 12A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-3622
Practice Address - Country:US
Practice Address - Phone:347-431-2880
Practice Address - Fax:347-281-7740
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHY LIVING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty