Provider Demographics
NPI:1902036395
Name:COMPREHENSIVE INTERVENTIONS, INC.
Entity Type:Organization
Organization Name:COMPREHENSIVE INTERVENTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING/BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAUSHIMA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-792-8035
Mailing Address - Street 1:PO BOX 1216
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-1216
Mailing Address - Country:US
Mailing Address - Phone:252-792-8035
Mailing Address - Fax:252-792-8045
Practice Address - Street 1:201 EAST ACADEMY STREET
Practice Address - Street 2:
Practice Address - City:ROBERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:27871
Practice Address - Country:US
Practice Address - Phone:252-795-4720
Practice Address - Fax:252-792-8045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1760522528Medicaid