| Organization Name: | COMMUNITY SERVICES PROGRAM |
| NPI Number: | 1184779274 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONNETTA JOHNSON (EXECUTIVE DIRECTOR) |
| Mailing Address: | 980 Catalina Laguna Beach |
| State: | CA US |
| Postal Code: | 926512748 |
| Phone Number: | 9494944311 |
| Fax Number: | 9494974861 |
| NPI Enumeration Date: | 01/25/2007 |
| NPI Last Update Date: | 01/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251V00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Voluntary or Charitable |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |