Community Support Network

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

COMMUNITY SUPPORT NETWORK

Practice address

634 Pressley St
Santa Rosa, CA 95404-5526

Phone

(707) 484-1326

NPI assigned

Feb 15, 2016

Organization subpart

No

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

Authorized official

Name

Sharon Shults

Title

Program Manager

Phone

(707) 484-1326

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1962861369",
    "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"
        },
        {
            "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": "707-484-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SUPPORT NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "SHULTS",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "707-484-1326"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Mental Illness Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.