Provider Demographics
NPI:1952179681
Name:COMPREHENSIVE HEALTH AND BEHAVIORAL SERVICES LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE HEALTH AND BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:BEBONGNCHU
Authorized Official - Last Name:NKEZE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:240-501-2710
Mailing Address - Street 1:1401 MERCANTILE LN STE 531
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4301
Mailing Address - Country:US
Mailing Address - Phone:410-304-6656
Mailing Address - Fax:
Practice Address - Street 1:1401 MERCANTILE LN STE 531
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4301
Practice Address - Country:US
Practice Address - Phone:410-304-6656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)