COMMUNITY SUPPORT SERVICES, INC. (NPI# 1336417641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336417641 |
| Entity Type | Organization |
| Organization Name | COMMUNITY SUPPORT SERVICES, INC. |
| Practice Address |
5062 N 19th Ave Ste 102 Phoenix AZ 85015-3225 |
| Mailing Address |
10645 N Tatum Blvd Phoenix AZ 85028-3068 |
| Practice Telephone | 4806295994 |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2019-06-20 |
| Authorized Official Name | ARLETTE ITAMI (PRESIDENT/CEO) |
| Authorized Official Telephone | 4806295994 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0050X |
Clinic/Center Specialization: Family Planning, Non-Surgical |
Ambulatory Health Care Facilities | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | BH-3873 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 247316 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093246340 | Community Support Services, Inc. | Community/Behavioral Health | 5540 W Glendale Ave Ste 102, Glendale, AZ 85301-2550 | 2017-03-27 |
| 1508027350 | Community Support Services, Inc. | Respite Care | 14292 E Evans Ave, Aurora, CO 80014-1432 | 2008-06-24 |
| 1124072111 | Community Support Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9075 Comprint Ct, Gaithersburg, MD 20877-1306 | 2006-05-22 |
| 1053309294 | Community Support Services, Inc. | Counselor | 150 Cross St, Akron, OH 44311-1026 | 2005-10-12 |
| 1033646468 | Community Support Services, Inc. | Local Education Agency (LEA) | 9075 Comprint Ct, Gaithersburg, MD 20877-1306 | 2017-05-16 |
| 1578008546 | Community Support Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9075 Comprint Ct, Gaithersburg, MD 20877-1306 | 2016-12-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY SUPPORT SERVICES, INC. | 9075 Comprint Ct, Gaithersburg, MD 20877-1306 |
| Oregon Corporations, Companies and Business Names | COMMUNITY SUPPORT SERVICES, INC. | 3276 Commercial St Se, Salem, OR 97302 |
| Street Address |
5062 N 19TH AVE STE 102 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85015-3225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154592707 | New Horizons Counseling Service Inc. | Community/Behavioral Health | 5062 N 19th Ave Ste 102, Phoenix, AZ 85015-3225 | 2008-03-21 |
| 1114531514 | Xavier Lewis Jenkins | Counselor | 5062 N 19th Ave Ste 102, Phoenix, AZ 85015-3225 | 2020-09-02 |
| 1538471321 | Gregory Waugh | Psychologist | 5062 N 19th Ave Ste 102, Phoenix, AZ 85015-3225 | 2010-07-08 |
| 1609104306 | Nelson Torres | Counselor | 5062 N 19th Ave Ste 102, Phoenix, AZ 85015-3225 | 2009-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610310 | Leticia Karina Maria Lelli | Student in an Organized Health Care Education/Training Program | 4760 N. 20th Ave, Phx, AZ 85015 | 2020-08-18 |
| 1083100564 | Leen Qutachi | Dentist | 1703 W Bethany Home Rd Ste C1, Phoenix, AZ 85015 | 2018-07-08 |
| 1851820146 | Jeff Biever | Spec/Tech, Cardiovascular | 1517 West Lamar Rd, Phoenix, AZ 85015 | 2017-06-08 |
| 1407230964 | Sean Noonan | Optometrist | 1703 W Bethany Home Rd Ste C3, Phoenix, AZ 85015 | 2015-07-15 |
| 1295141620 | Yehia Saleh | Pharmacist | 4040 North 19th Avenue, Cvs Pharmacy, Phoenix, AZ 85015 | 2014-07-07 |
| 1295160380 | Journey To Prosperity | Custodial Care Facility | 1623 W Denton, Phoenix, AZ 85015 | 2013-09-07 |
| 1124372099 | Facing The Future With Hope | Counselor | 5656 N 17th Ave #c7, Phoenix, AZ 85015 | 2012-10-31 |
| 1700133998 | Srujal Vinubhai Patel | Internal Medicine | 6036 N 19th Ave Ste 312, Phoenix, AZ 85015 | 2012-08-07 |
| 1689933947 | Modern Dental Professionals - Arizona PC | Dentist | 2131 E Camelback Road, Ste 102, Phoenix, AZ 85015 | 2012-05-08 |
| 1528360674 | Fatima Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 2025 W Indian School Road, #705, Phoenix, AZ 85015 | 2010-11-23 |
| Find all providers in zip 85015 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384030 | Great Xpectations LLC | Community/Behavioral Health | 4014 W Christy Dr, Phoenix, AZ 85029-3958 | 2020-10-19 |
| 1386242295 | Mercy Cares LLC | Community/Behavioral Health | 2644 E Paradise Ln Apt D, Phoenix, AZ 85032-2945 | 2020-10-13 |
| 1124626080 | Beia's Families | Community/Behavioral Health | 3230 E Broadway Rd Ste C-235, Phoenix, AZ 85040-2873 | 2020-10-13 |
| 1518564442 | Infinity Groups Homes LLC | Community/Behavioral Health | 3523 E Everett Dr, Phoenix, AZ 85032-5136 | 2020-10-05 |
| 1013524230 | Civara Behavioral Health LLC | Community/Behavioral Health | 4010 W Cactus Rd, Phoenix, AZ 85029-2905 | 2020-10-01 |
| 1043827561 | Crossroads, Inc | Community/Behavioral Health | 2002 E Osborn Rd, Phoenix, AZ 85016-7236 | 2020-09-29 |
| 1043827025 | Guiding Steps Health Services, LLC | Community/Behavioral Health | 4926 E Mcdowell Rd, Phoenix, AZ 85008-4294 | 2020-09-24 |
| 1154931566 | Apex Transitional Housing Inc | Community/Behavioral Health | 13827 N 11th St, Phoenix, AZ 85022-4316 | 2020-08-01 |
| 1356959126 | Rock House Az, LLC | Community/Behavioral Health | 8650 N 35th Ave Ste 110, Phoenix, AZ 85051-3835 | 2020-07-17 |
| 1215554902 | Lydia Barton | Community/Behavioral Health | 1420 W Missouri Ave, Phoenix, AZ 85013-1919 | 2020-06-29 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.