MEDICARE: COMMUNITY SUPPORT PROGRAMS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1821381161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY SUPPORT PROGRAMS, INC.

Provider Business Mailing Address
First Line	:	3000 KNIGHT ST
Second Line	:	STE 100
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2502
Country	:	US
Telephone Number	:	318-865-1422
Fax Number	:	318-865-4566

Provider Business Practice Location Address
First Line	:	3000 KNIGHT ST
Second Line	:	STE 100
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2502
Country	:	US
Telephone Number	:	318-865-1422
Fax Number	:	318-865-4566

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MARGARET GAFFNEY SHEMWELL
Credential	:	LCSW
Telephone Number	:	318-865-1422

Provider Enumeration Date	:	05/19/2011
Last Update Date	:	09/20/2011

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