Organization Name: | COMMUNITY SUPPORT NETWORK |
NPI Number: | 1922121581 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAURELIN COGGINS-LEWIS (PROGRAM MANAGER) |
Mailing Address: | 420 E Cotati Ave Cotati |
State: | CA US |
Postal Code: | 949314442 |
Phone Number: | 7077954336 |
Fax Number: | 7077953306 |
NPI Enumeration Date: | 04/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |