NPIMap

Organization Active NPI

Community Support Network

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Santa Rosa, CA
National Provider Identifier
1992828966
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
490111656 Issued in CA
Legal business name
COMMUNITY SUPPORT NETWORK
Practice address
1550 N. Dutton Ave
Santa Rosa, CA 95401
Phone
(707) 573-6962
Fax
(707) 573-6967
NPI assigned
Apr 6, 2007
Organization subpart
Yes
Parent organization
COMMUNITY SUPPORT NETWORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Authorized official

Name
Rosemary Devitt, M.A.
Title
Director of Finance Admin.
Phone
(707) 575-0979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 490111656 CA Primary

Addresses

Primary practice location

1550 N. Dutton Ave
Santa Rosa, CA 95401

Mailing address

1410 Guerneville Rd
Suite 14
Santa Rosa, CA 94503
Phone (707) 575-0979

Other names 1

  • CSN Dutton Doing business as

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.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1992828966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 GUERNEVILLE RD",
            "address_2": "SUITE 14",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "94503",
            "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": "1550 N. DUTTON AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95401",
            "telephone_number": "707-573-6962",
            "fax_number": "707-573-6967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SUPPORT NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY SUPPORT NETWORK",
        "enumeration_date": "2007-04-06",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "DEVITT",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE ADMIN.",
        "authorized_official_telephone_number": "707-575-0979",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "490111656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSN Dutton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 16, 2008; 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.