Healthcare Provider Details

I. General information

NPI: 1508027350
Provider Name (Legal Business Name): COMMUNITY SUPPORT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14292 E EVANS AVE
AURORA CO
80014-1432
US

IV. Provider business mailing address

14292 E EVANS AVE
AURORA CO
80014-1432
US

V. Phone/Fax

Practice location:
  • Phone: 720-870-3712
  • Fax: 720-870-3743
Mailing address:
  • Phone: 720-870-3712
  • Fax: 720-870-3743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State

VIII. Authorized Official

Name: REBECCA SUE BARTELS
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 720-870-3712