Provider Demographics
NPI:1134372162
Name:COMPREHENSIVE COMMUNITY SERVICES, INC
Entity type:Organization
Organization Name:COMPREHENSIVE COMMUNITY SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:REVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDAVID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-928-6581
Mailing Address - Street 1:2514 1/2 WESLEY ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1752
Mailing Address - Country:US
Mailing Address - Phone:423-928-6581
Mailing Address - Fax:423-928-6215
Practice Address - Street 1:2514 1/2 WESLEY ST
Practice Address - Street 2:SUITE 5
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1752
Practice Address - Country:US
Practice Address - Phone:423-928-6581
Practice Address - Fax:423-928-6215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10000000029493245S0500X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children