1396324422 NPI number — COMPREHENSIVE PSYCHIATRIC SOLUTIONS, P.C.

Table of content: KRISTIN DICKHONER BRANDSTETTER RD (NPI 1750566634)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396324422 NPI number — COMPREHENSIVE PSYCHIATRIC SOLUTIONS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPREHENSIVE PSYCHIATRIC SOLUTIONS, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396324422
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1450 W LONG LAKE RD STE 340
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TROY
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48098-6330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-905-5091
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 SENECA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VENTURA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93001-1411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-653-6434
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2021

Additional Information

Authorized Official

Authorized Official Last Name:
ATTAR
Authorized Official First Name:
HANA
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED REPRESENTATIVE
Authorized Official Telephone Number:
248-905-5091

Provider Taxonomy Codes

  • Taxonomy code: 2084P0802X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com