Organization Name: | COMPREHENSIVE CARE CENTER INC NORTH PORT |
NPI Number: | 1013269851 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL CUFFAGE (CEO) |
Mailing Address: | 1231 N Tuttle Ave Sarasota |
State: | FL US |
Postal Code: | 342373116 |
Phone Number: | 9413660134 |
Fax Number: | 9419511795 |
NPI Enumeration Date: | 10/03/2012 |
NPI Last Update Date: | 10/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |