Provider Demographics
NPI:1912420696
Name:COMPREHENSIVE INNOVATIVE HEALTH SERVICES
Entity type:Organization
Organization Name:COMPREHENSIVE INNOVATIVE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CLAUD
Authorized Official - Suffix:
Authorized Official - Credentials:MNM
Authorized Official - Phone:561-722-8055
Mailing Address - Street 1:100 VILLAGE SQUARE XING STE 202
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4531
Mailing Address - Country:US
Mailing Address - Phone:561-722-8055
Mailing Address - Fax:
Practice Address - Street 1:5829 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2021
Practice Address - Country:US
Practice Address - Phone:561-722-8055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care