Provider Demographics
NPI:1871896092
Name:COMPREHENSIVE SUPPORT SERVICES, INC.
Entity type:Organization
Organization Name:COMPREHENSIVE SUPPORT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL/WAIVER SUPPORT COORDINATO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-345-0397
Mailing Address - Street 1:7240 NW 63RD TER
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4753
Mailing Address - Country:US
Mailing Address - Phone:954-345-0397
Mailing Address - Fax:954-345-2366
Practice Address - Street 1:7240 NW 63RD TER
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-4753
Practice Address - Country:US
Practice Address - Phone:954-345-0397
Practice Address - Fax:954-345-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL688453998Medicaid
FL673419796Medicaid