Provider Demographics
NPI:1972670628
Name:COMPREHENSIVE COMMUNITY CARE, INC.
Entity Type:Organization
Organization Name:COMPREHENSIVE COMMUNITY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF QUALITY ASSURANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTS-GOWINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-402-0323
Mailing Address - Street 1:3308 DURHAM CHAPEL HILL BLVD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2694
Mailing Address - Country:US
Mailing Address - Phone:919-402-0323
Mailing Address - Fax:919-402-9435
Practice Address - Street 1:3308 DURHAM CHAPEL HILL BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2694
Practice Address - Country:US
Practice Address - Phone:919-402-0323
Practice Address - Fax:919-402-9435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408643Medicaid
NC3408643Medicaid