| NPI | 1942833686 |
|---|---|
| Doing Business As | COMTREA |
| Entity Type | Organization |
| Authorized Contact | TERESA L PORTER Credentialing Manager 660-890-8156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2023-07-04 |