Provider Demographics
NPI:1598138877
Name:COMPREHENSIVE WELLNESS CENTERS LLC
Entity type:Organization
Organization Name:COMPREHENSIVE WELLNESS CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:TUNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-619-5858
Mailing Address - Street 1:720 S DIXIE HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-4652
Mailing Address - Country:US
Mailing Address - Phone:561-619-5858
Mailing Address - Fax:
Practice Address - Street 1:660 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-4607
Practice Address - Country:US
Practice Address - Phone:561-619-5858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X, 323P00000X, 283Q00000X
FL324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL118858700Medicaid