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General NPI Number Information
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NPI Number | 1033286356
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Entity Type | Organization
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Legal Business Name | COMMUNITY-BASED SERVICES & CONSULTING GROUP, INC.
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 20491 THE GRANADA
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City | DUNNELLON
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State | FL
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Zip | 34432-6064
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Country | US
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Telephone | 352-465-3551
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Fax |
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Provider Business Mailing Address
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Address Line | 16083 SW 22ND LN
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City | OCALA
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State | FL
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Zip | 34481-8729
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Country | US
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Telephone | 352-465-3551
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Fax | 352-465-3549
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. RICKEY D STANDRIDGE
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Credential |
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Telephone | 352-465-3551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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