Provider Demographics
NPI:1700883790
Name:COMPREHENSIVE CARE, INC..
Entity type:Organization
Organization Name:COMPREHENSIVE CARE, INC..
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRANMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-390-9909
Mailing Address - Street 1:1451 HIGH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-6447
Mailing Address - Country:US
Mailing Address - Phone:636-390-9510
Mailing Address - Fax:636-390-8992
Practice Address - Street 1:1451 HIGH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-6447
Practice Address - Country:US
Practice Address - Phone:636-390-9909
Practice Address - Fax:636-390-8992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00010647251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO267579Medicare ID - Type Unspecified