Provider Demographics
NPI:1598141871
Name:COMPREHENSIVE COMMUNITY CARE
Entity Type:Organization
Organization Name:COMPREHENSIVE COMMUNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTS GOWINS
Authorized Official - Suffix:
Authorized Official - Credentials:QDDP
Authorized Official - Phone:919-489-4202
Mailing Address - Street 1:3308 DURHAM CHAPEL HILL BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2694
Mailing Address - Country:US
Mailing Address - Phone:919-402-0323
Mailing Address - Fax:919-402-9435
Practice Address - Street 1:804 PARK RIDGE RD
Practice Address - Street 2:APT 8A
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9227
Practice Address - Country:US
Practice Address - Phone:919-548-8938
Practice Address - Fax:919-493-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408643Medicaid