Provider Demographics
NPI:1720432727
Name:COMPREHENSIVE THERAPY ASSOCIATES, INC
Entity Type:Organization
Organization Name:COMPREHENSIVE THERAPY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NEKTAR
Authorized Official - Middle Name:
Authorized Official - Last Name:DADURYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-935-1574
Mailing Address - Street 1:5419 HOLLYWOOD BLVD STE C416
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-3480
Mailing Address - Country:US
Mailing Address - Phone:310-935-1574
Mailing Address - Fax:310-997-0396
Practice Address - Street 1:111 N JACKSON ST STE 202
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4371
Practice Address - Country:US
Practice Address - Phone:310-935-1574
Practice Address - Fax:310-997-0396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-16
Last Update Date:2016-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11410454251B00000X
CASP1468251C00000X
CAOT9304251C00000X
CA150179858251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management