Provider Demographics
NPI:1285260463
Name:COMPREHENSIVE CARE SERVICES AGENCY, LLC
Entity type:Organization
Organization Name:COMPREHENSIVE CARE SERVICES AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ABETY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-351-5828
Mailing Address - Street 1:6000 SPRINGHILL DR APT 204
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3165
Mailing Address - Country:US
Mailing Address - Phone:706-351-5828
Mailing Address - Fax:
Practice Address - Street 1:8115 FENTON ST STE 213
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-6701
Practice Address - Country:US
Practice Address - Phone:706-351-5828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-19
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health