Provider Demographics
NPI:1841465028
Name:COMPREHENSIVE RESIDENTIAL SYSTEMS, INC.
Entity type:Organization
Organization Name:COMPREHENSIVE RESIDENTIAL SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:PURNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-802-3815
Mailing Address - Street 1:4202 TAVERNGREEN LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3541
Mailing Address - Country:US
Mailing Address - Phone:301-809-0050
Mailing Address - Fax:443-703-2331
Practice Address - Street 1:4202 TAVERNGREEN LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3541
Practice Address - Country:US
Practice Address - Phone:301-809-0050
Practice Address - Fax:443-703-2331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDDA 20648-07320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities