1609023951 NPI number — COMMUNITY SERVICES FOR CHILDREN

Table of content: (NPI 1609023951)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609023951 NPI number — COMMUNITY SERVICES FOR CHILDREN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY SERVICES FOR CHILDREN
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:
1609023951
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 98
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BANNER ELK
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28604-0098
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-898-5465
Provider Business Mailing Address Fax Number:
828-898-6140

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1796 HENDERSONVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28803-2498
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-898-5465
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/19/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SWINKOLA
Authorized Official First Name:
JIM
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
828-898-5465

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C005821 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 4244 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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