| Organization Name: | COMPREHENSIVE CARE CLINIC |
| NPI Number: | 1205270410 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FAIZMOHAMED M MANSURI (PHYSICIAN) |
| Mailing Address: | 340 Montage Mountain Rd Moosic |
| State: | PA US |
| Postal Code: | 185071782 |
| Phone Number: | 5705890707 |
| Fax Number: | |
| NPI Enumeration Date: | 04/18/2013 |
| NPI Last Update Date: | 04/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | MD427029 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |