Basic Information
| Provider Information | |||||||||
| NPI: | 1780918193 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMPREHENSIVE CARE SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31330 SCHOOLCRAFT RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481502041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7345259712 | ||||||||
| FaxNumber: | 7345259582 | ||||||||
| Practice Location | |||||||||
| Address1: | 31330 SCHOOLCRAFT RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481502041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7345259712 | ||||||||
| FaxNumber: | 7345259582 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2009 | ||||||||
| LastUpdateDate: | 10/01/2009 | ||||||||
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| AuthorizedOfficialLastName: | CZAPLICKA | ||||||||
| AuthorizedOfficialFirstName: | CHESTER | ||||||||
| AuthorizedOfficialMiddleName: | FRANK | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7345259712 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | CCP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 242T00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Technologists, Technicians & Other Technical Service Providers | Perfusionist |
No ID Information.