Provider Demographics
NPI:1689852170
Name:COMBS RESIDENTIAL SERVICE, INC.
Entity Type:Organization
Organization Name:COMBS RESIDENTIAL SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-379-5117
Mailing Address - Street 1:11455 NORTH HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:EUBANK
Mailing Address - State:KY
Mailing Address - Zip Code:42567
Mailing Address - Country:US
Mailing Address - Phone:606-379-5117
Mailing Address - Fax:606-379-6478
Practice Address - Street 1:11455 NORTH HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:EUBANK
Practice Address - State:KY
Practice Address - Zip Code:42567
Practice Address - Country:US
Practice Address - Phone:606-379-5117
Practice Address - Fax:606-379-6478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health