Provider Demographics
NPI:1912387184
Name:COMPREHENSIVE BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:COMPREHENSIVE BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SCHAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP
Authorized Official - Phone:651-388-0051
Mailing Address - Street 1:2835 S SERVICE DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-1882
Mailing Address - Country:US
Mailing Address - Phone:651-388-0051
Mailing Address - Fax:
Practice Address - Street 1:2835 S SERVICE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-1882
Practice Address - Country:US
Practice Address - Phone:651-388-0051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10968261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health