Provider Demographics
NPI:1760728661
Name:COMPLETE HEALTH CARE FOR WOMEN INC
Entity Type:Organization
Organization Name:COMPLETE HEALTH CARE FOR WOMEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL RESEARCH
Authorized Official - Prefix:DR
Authorized Official - First Name:MILROY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-578-8582
Mailing Address - Street 1:5888 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-2815
Mailing Address - Country:US
Mailing Address - Phone:614-882-4343
Mailing Address - Fax:614-882-4664
Practice Address - Street 1:5888 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-2815
Practice Address - Country:US
Practice Address - Phone:614-882-4343
Practice Address - Fax:614-882-4664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH061029101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty