Community Social Integration, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

COMMUNITY SOCIAL INTEGRATION, LLC

Practice address

2666 State St Ste 6
Hamden, CT 06517-2232

Phone

(203) 287-1543

Fax

(203) 407-1625

NPI assigned

Feb 24, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Curtis Lamont Gibson

Title

Owner

Phone

(203) 980-5479

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1053945659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2666 STATE ST STE 6",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065172232",
            "telephone_number": "203-287-1543",
            "fax_number": "203-407-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2666 STATE ST STE 6",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065172232",
            "telephone_number": "203-287-1543",
            "fax_number": "203-407-1625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1972 Don Juan Ln",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300324217",
            "country_code": "US",
            "telephone_number": "203-980-5479",
            "fax_number": "203-407-1625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY SOCIAL INTEGRATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_middle_name": "LAMONT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-980-5479",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003212605A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003212605B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emmanuel Colon, LICENSED OPTICIAN
• Veronica Colon, RN
• Leila Colson, APRN
• Emily R Comer, OTR/L
• Community Partners in Action
• Philip J Conforti, DDS
• Gina M Confredo
• Diana Congdon, APRN
• Connecticut CVS Pharmacy LLC
• Connecticut CVS Pharmacy, L.L.C.

• All providers in Hamden, CT
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.