Healthcare Provider Details

I. General information

NPI: 1124835186
Provider Name (Legal Business Name): COMMUNITY SUPPORT INITIATIVE (CSI), CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2024
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2251 FLORIN RD STE 96
SACRAMENTO CA
95822-4483
US

IV. Provider business mailing address

2251 FLORIN RD STE 96
SACRAMENTO CA
95822-4483
US

V. Phone/Fax

Practice location:
  • Phone: 916-400-3102
  • Fax: 916-400-3261
Mailing address:
  • Phone: 916-831-8267
  • Fax: 916-400-3261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLYN HILL
Title or Position: CEO
Credential:
Phone: 916-831-8267