Provider Demographics
NPI:1821266438
Name:COMPREHENSIVE BEHAVIORAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GUIBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:419-794-0567
Mailing Address - Street 1:2770 CENTENNIAL RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1829
Mailing Address - Country:US
Mailing Address - Phone:419-794-0569
Mailing Address - Fax:419-794-0567
Practice Address - Street 1:2770 CENTENNIAL RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1829
Practice Address - Country:US
Practice Address - Phone:419-794-0569
Practice Address - Fax:419-794-0567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-16
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002285-S101YP2500X
OHS0017942104100000X
OHI7740-S1041C0700X
OHI0010140-S1041C0700X
OHI00096741041C0700X
OHI0002506-S1041C0700X
OH350840272084P0804X
OH350840812084P0804X
OH350782432084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3060002Medicaid
OH36D1098204OtherCLIA
OH3060002Medicaid