NPIMap

Organization Active NPI

Community Support Networkr

  • Case Management Agency
  • Santa Rosa, CA
National Provider Identifier
1851617062
Registry record updated Apr 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
COMMUNITY SUPPORT NETWORKR
Practice address
634 Pressley St
Santa Rosa, CA 95404-5526
Phone
(707) 573-6955
Fax
(707) 543-8176
NPI assigned
Apr 13, 2010
Organization subpart
Yes
Parent organization
COMMUNITY SUPPORT NETWORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 13, 2010

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

Authorized official

Name
Ms. Cathy Lee Carr, COUNSELOR
Title
Program Manager
Phone
(707) 573-6955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

634 Pressley St
Santa Rosa, CA 95404-5526

Mailing address

634 Pressley St
Santa Rosa, CA 95404-5526
Phone (707) 573-6955

Other identifiers 1

IdentifierTypeStateIssuer
56789OtherCAMEDICAL

Other names 1

  • Oportunity House Other name

National Provider Directory

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

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": "1271116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271116800000",
    "number": "1851617062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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 SUPPORT NETWORKR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY SUPPORT NETWORK",
        "enumeration_date": "2010-04-13",
        "last_updated": "2010-04-13",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "707-573-6955",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "COUNSELOR"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "56789",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oportunity House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 13, 2010; 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.