COMMUNITY SUPPORT NETWORK (NPI# 1396954087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396954087 |
Entity Type | Organization |
Organization Name | COMMUNITY SUPPORT NETWORK |
Practice Address |
21 Faye Ct Petaluma CA 94952-2202 |
Practice Telephone | 7077650102 |
Practice Fax Number | 7077650124 |
Mailing Telephone | 7077650102 |
Mailing Fax Number | 7077650124 |
Enumeration Date | 2007-05-21 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MS. ALLISON BALL (PROGRAM MANAGER) |
Authorized Official Telephone | 7077650102 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | CA | Residential Treatment Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619276839 | Community Support Network | Case Management | 2749 1st Ave N, St Petersburg, FL 33713-8723 | 2011-03-28 |
1386869246 | Community Support Network | Community Based Residential Treatment Facility, Mental Illness | 201 S E St, Santa Rosa, CA 95404-4709 | 2007-04-16 |
1427272004 | Community Support Network | Community Based Residential Treatment Facility, Mental Illness | 112 Brown St, Santa Rosa, CA 95404-5007 | 2007-04-13 |
1922121581 | Community Support Network | Community Based Residential Treatment Facility, Mental Illness | 420 E Cotati Ave, Cotati, CA 94931-4442 | 2007-04-09 |
1992828966 | Community Support Network | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1550 N. Dutton Ave, Santa Rosa, CA 95401 | 2007-04-06 |
1962861369 | Community Support Network | Community Based Residential Treatment Facility, Mental Illness | 634 Pressley St, Santa Rosa, CA 95404-5526 | 2016-02-15 |
1255656609 | Community Support Network | Community/Behavioral Health | 3595 Sullivant Ave, Columbus, OH 43228-2121 | 2010-03-29 |
1336349398 | Community Support Network | Community Based Residential Treatment Facility, Mental Illness | 634 Pressley St, Santa Rosa, CA 95404-5526 | 2007-07-18 |
1225259179 | Community Support Network | Case Management | 634 Pressley St, Santa Rosa, CA 95403 | 2007-05-01 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | COMMUNITY SUPPORT NETWORK | 8221 Sw Mariners Dr, Wilsonville, OR 97070 |
Street Address |
21 FAYE CT |
City | PETALUMA |
State | CA |
Zip Code | 94952-2202 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114587680 | Benjamin R Idarius | Behavior Technician | 101 H St. Ste. L, Petaluma, CA 94952 | 2019-06-17 |
1518457159 | Kyleen Joan Romero | Behavioral Analyst | 25 Graylawn Ave, Petaluma, CA 94952 | 2018-05-17 |
1437647526 | John Scruggs | Behavior Technician | 301 H St. Suit L, Petaluma, CA 94952 | 2018-04-25 |
1811404684 | Brief and Strategic Counseling Service | Counselor | 843 Chardonnay Cir., Petaluma, CA 94952 | 2018-01-03 |
1730638396 | Jennifer Lee Sloan | Acupuncturist | 517 Hayes Lane, Petaluma, CA 94952 | 2016-09-23 |
1982057295 | Elene Hwa-yihg Chung | Acupuncturist | 130 Graylawn Ave.,#f, Petaluma, CA 94952 | 2016-07-21 |
1457773624 | Lisa Hirsch Cordeiro | Marriage & Family Therapist | 700 Sixth Street, Petaluma, CA 94952 | 2014-01-07 |
1811271075 | Jacques Philippe Archer | Massage Therapist | 131b Kentucky St., Petaluma, CA 94952 | 2011-10-06 |
1477841609 | Karna Licia Dawson | Social Worker | 205 Keller St., Petaluma, CA 94952 | 2011-07-21 |
1497051783 | Melissa Beth Wilson | Acupuncturist | 155a Kentucky Street, Petaluma, CA 94952 | 2011-02-03 |
Find all providers in zip 94952 |
Taxonomy Code | 320800000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment Facility, Mental Illness |
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215538244 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 10525 Fuerte Dr, La Mesa, CA 91941-4350 | 2020-11-05 |
1154922458 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 24171 Grayston Dr, Lake Forest, CA 92630-3839 | 2020-11-03 |
1003417684 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 1155 Hoover St, Carlsbad, CA 92008-4230 | 2020-11-02 |
1497356075 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 405 N Tremont St, Oceanside, CA 92054-2535 | 2020-11-02 |
1467053041 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 6477 Goldenbush Dr, Carlsbad, CA 92011-4203 | 2020-11-02 |
1366043937 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 26065 Waterwheel Pl, Laguna Hills, CA 92653-6114 | 2020-11-02 |
1730780313 | Orchid Court, Inc. | Community Based Residential Treatment Facility, Mental Illness | 307 S Arrowhead Avenue, San Bernardino, CA 92408-1325 | 2020-11-02 |
1477151199 | Inspiring Pathways, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1798 Bryman St, Hanford, CA 93230-7144 | 2020-10-14 |
1356949226 | Wings Recovery Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3134 Morningside Dr, Oceanside, CA 92056-4401 | 2020-10-13 |
1326645904 | New Passages Group Home, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5675 E Ashlan Ave, Fresno, CA 93727-7220 | 2020-10-06 |
Find all providers with the same taxonomy |
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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.