Provider Demographics
NPI:1982966008
Name:COMPREHENSIVE HEALTH SERVICES OF GREATER ATLANTA LLC
Entity type:Organization
Organization Name:COMPREHENSIVE HEALTH SERVICES OF GREATER ATLANTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-471-0255
Mailing Address - Street 1:2950 BUFORD HWY
Mailing Address - Street 2:STE 140
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-8215
Mailing Address - Country:US
Mailing Address - Phone:678-471-0255
Mailing Address - Fax:
Practice Address - Street 1:2950 BUFORD HWY
Practice Address - Street 2:STE 140
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-8215
Practice Address - Country:US
Practice Address - Phone:678-471-0255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA111N00000X, 208D00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty