COMMUNITY SUPPORT NETWORK (NPI# 1992828966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992828966 |
| Entity Type | Organization |
| Organization Name | COMMUNITY SUPPORT NETWORK |
| Other Organization Name | CSN DUTTON |
| Practice Address |
1550 N. Dutton Ave Santa Rosa CA 95401 |
| Mailing Address |
1410 Guerneville Rd Suite 14 Santa Rosa CA 94503 |
| Practice Telephone | 7075736962 |
| Practice Fax Number | 7075736967 |
| Mailing Telephone | 7075750979 |
| Mailing Fax Number | 7075736968 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2008-07-16 |
| Authorized Official Name | ROSEMARY DEVITT (DIRECTOR OF FINANCE ADMIN.) |
| Authorized Official Telephone | 7075750979 |
| Authorized Official Credential | M.A. |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY SUPPORT NETWORK |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 490111656 | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| CSN Dutton | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619276839 | Community Support Network | Case Management | 2749 1st Ave N, St Petersburg, FL 33713-8723 | 2011-03-28 |
| 1396954087 | Community Support Network | Community Based Residential Treatment Facility, Mental Illness | 21 Faye Ct, Petaluma, CA 94952-2202 | 2007-05-21 |
| 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 |
| 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 |
1550 N. DUTTON AVE |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972148575 | Megan Elizabeth Jones | In Home Supportive Care | 1239 Eardley Ave, Santa Rosa, CA 95401 | 2019-11-07 |
| 1801447230 | Patty Macisaac | Technician | 3221 Oak Farm Lane, Santa Rosa, CA 95401 | 2019-09-26 |
| 1386114981 | Victoria Maria Guillory | Dental Hygienist | 140 Stony Point Road, Suite A, Santa Rosa, CA 95401 | 2018-11-27 |
| 1811470727 | Chemarin Eve Boyd | Student in an Organized Health Care Education/Training Program | 1260 N Dutton Avenue, 225, Santa Rosa, CA 95401 | 2018-09-07 |
| 1073008181 | Cristavel Camacho | Behavioral Analyst | 1439 Range Ave, #101, Santa Rosa, CA 95401 | 2018-06-30 |
| 1619479102 | Victoria King | Behavior Technician | 1335 N. Dutton Ave., Santa Rosa, CA 95401 | 2018-03-01 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1720530587 | Compassionate Homecare Solutions, LLC | In Home Supportive Care | 131 A Stony Circle, Suite 500, Santa Rosa, CA 95401 | 2016-10-27 |
| 1366998981 | William Glenn | Marriage & Family Therapist | 1496 Willowside Road, Santa Rosa, CA 95401 | 2016-09-01 |
| 1790144046 | Advocacy Home Nursing, Inc | Home Health | 1400 North Dutton Avenue, Suite 20, Santa Rosa, CA 95401 | 2016-02-15 |
| Find all providers in zip 95401 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770620734 | My Home Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1639 Manzanita Avenue, Santa Rosa, CA 95404 | 2007-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538776323 | Calston Manor | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 44661 Calston Ave, Lancaster, CA 93535-3430 | 2020-09-25 |
| 1457966822 | Invincible Villas, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 27539 Glasser Ave, Canyon Country, CA 91351-2039 | 2020-09-12 |
| 1528671633 | Eliaa, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1229 Kelley Avenue, Corona, CA 92882-4207 | 2020-08-28 |
| 1902417090 | Kavere Services Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 531 N Mills Ave, Lodi, CA 95242-2220 | 2020-08-12 |
| 1568071488 | Jnp Residential | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1518 S Wadsworth Ave, Compton, CA 90220-3951 | 2020-07-27 |
| 1043833734 | E&s Jensen Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9629 Ridgerock Dr, Elk Grove, CA 95624-4461 | 2020-05-28 |
| 1124663588 | The Caring Bunch | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4355 Sepulveda Blvd Apt 125, Sherman Oaks, CA 91403-3911 | 2019-11-08 |
| 1821655507 | Creative Lifestyles Home Care Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1022 W Florence Ave, Los Angeles, CA 90044-2442 | 2019-05-28 |
| 1386160562 | Blueprint Development Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2501 Sycamore Ln, Palmdale, CA 93551-1518 | 2017-08-18 |
| 1427592963 | Carissa Group Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1048 Stowell Ranch Cir, Corona, CA 92881-4739 | 2016-12-16 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA |
| Zip Code | 95401 |
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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.