Provider Demographics
NPI:1871797704
Name:COMPREHENSIVE BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:COMPREHENSIVE BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-256-2006
Mailing Address - Street 1:384D CARRIAGE HOUSE DRIVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2268
Mailing Address - Country:US
Mailing Address - Phone:731-256-2006
Mailing Address - Fax:731-256-2007
Practice Address - Street 1:384D CARRIAGE HOUSE DRIVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2268
Practice Address - Country:US
Practice Address - Phone:731-256-2006
Practice Address - Fax:731-256-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000108574251J00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing CareGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN39014561Medicaid
TN3901456Medicaid
TN39014561Medicare PIN
TN33416502Medicare PIN
TN3901456Medicare PIN