1073659967 NPI number — COMMUNITY SOLUTIONS, INC.

Table of content: (NPI 1073659967)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073659967 NPI number — COMMUNITY SOLUTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY SOLUTIONS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073659967
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
175 ADDISON RD STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINDSOR
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06095-2179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-539-7745
Provider Business Mailing Address Fax Number:
860-683-7181

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
546 W HAMILTON ST
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18101-1503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-435-3343
Provider Business Practice Location Address Fax Number:
610-435-7211
Provider Enumeration Date:
01/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PROVOST
Authorized Official First Name:
NATHAN
Authorized Official Middle Name:
RUSSELL
Authorized Official Title or Position:
CONTROLLER
Authorized Official Telephone Number:
860-539-7745

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 101500041 0001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1015000410002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com