Provider Demographics
NPI:1538322433
Name:COMPREHENSIVE BEHAVIOR HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE BEHAVIOR HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LATISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLOUGHBY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:252-753-6300
Mailing Address - Street 1:3396 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27828-1376
Mailing Address - Country:US
Mailing Address - Phone:252-752-6300
Mailing Address - Fax:252-753-6303
Practice Address - Street 1:2109 SAINT ANDREW ST SUITE-A
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-2149
Practice Address - Country:US
Practice Address - Phone:252-823-1188
Practice Address - Fax:252-823-1189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health