Provider Demographics
NPI:1104173855
Name:CENTER FOR COMPREHENSIVE SERVICES, INC DBA NEURORESTORATIVE KENTUCKY
Entity type:Organization
Organization Name:CENTER FOR COMPREHENSIVE SERVICES, INC DBA NEURORESTORATIVE KENTUCKY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-529-3060
Mailing Address - Street 1:PO BOX 2825
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62902-2825
Mailing Address - Country:US
Mailing Address - Phone:618-529-3060
Mailing Address - Fax:618-529-2983
Practice Address - Street 1:11901 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1040
Practice Address - Country:US
Practice Address - Phone:502-491-0941
Practice Address - Fax:502-491-0942
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MENTOR ABI, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-13
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital