NPIMap

Organization Active NPI

Community Suppport Network

  • Mental Illness Community Based Residential Treatment Facility
  • Santa Rosa, CA
National Provider Identifier
1831219989
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
COMMUNITY SUPPPORT NETWORK
Practice address
634 Pressley St
Santa Rosa, CA 95404-5526
Phone
(707) 573-6955
Fax
(707) 543-8176
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Authorized official

Name
Mrs. Rita Larson
Title
Director of Social Rehabilitation
Phone
(707) 575-0979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X CA Primary

Addresses

Primary practice location

634 Pressley St
Santa Rosa, CA 95404-5526

Mailing address

1410 Guerneville Rd
14
Santa Rosa, CA 95403-7231
Phone (707) 575-0979

National Provider Directory

National Provider Directory
Tax ID family
CSN- Bridges9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1831219989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 GUERNEVILLE RD",
            "address_2": "14",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954037231",
            "telephone_number": "707-575-0979",
            "fax_number": "707-573-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 PRESSLEY ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045526",
            "telephone_number": "707-573-6955",
            "fax_number": "707-543-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SUPPPORT NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "RITA",
        "authorized_official_title_or_position": "DIRECTOR OF SOCIAL REHABILITATION",
        "authorized_official_telephone_number": "707-575-0979",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.