Healthcare Provider Details

I. General information

NPI: 1871553123
Provider Name (Legal Business Name): COMMUNITY SOLUTIONS ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 HIGH ST NE
WARREN OH
44481-1222
US

IV. Provider business mailing address

320 HIGH ST NE
WARREN OH
44481-1222
US

V. Phone/Fax

Practice location:
  • Phone: 330-394-9090
  • Fax:
Mailing address:
  • Phone: 330-394-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH LLOYD
Title or Position: PRESIDENT
Credential:
Phone: 330-394-9090