Provider Demographics
NPI:1942426549
Name:COMPREHENSIVE THERAPY CENTERS, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE THERAPY CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:702-932-4308
Mailing Address - Street 1:3602 E SUNSET RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-7202
Mailing Address - Country:US
Mailing Address - Phone:702-932-4308
Mailing Address - Fax:702-837-8930
Practice Address - Street 1:1420 E CALVADA BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-3974
Practice Address - Country:US
Practice Address - Phone:775-727-4700
Practice Address - Fax:775-727-7970
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE THERAPY CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-18
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20021124290225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100505893Medicaid
NVV100628Medicare PIN