Provider Demographics
NPI:1528545860
Name:CENTRALCOMP SERVICES LLC
Entity Type:Organization
Organization Name:CENTRALCOMP SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:TSOURAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-875-3064
Mailing Address - Street 1:1113 MURFREESBORO RD # 106-324
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-1306
Mailing Address - Country:US
Mailing Address - Phone:877-875-3064
Mailing Address - Fax:877-875-3142
Practice Address - Street 1:1113 MURFREESBORO RD # 106-324
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-1306
Practice Address - Country:US
Practice Address - Phone:877-875-3064
Practice Address - Fax:877-875-3142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty