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General NPI Number Information
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NPI Number | 1083576573
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Entity Type | Organization
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Legal Business Name | CORE COMMUNITY SUPPORTS LLC
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 5005 S LA BREA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90056-1803
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Country | US
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Telephone | 323-204-0200
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Fax | 323-204-0220
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Provider Business Mailing Address
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Address Line | 4500 PARK GRANADA STE 202
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City | CALABASAS
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State | CA
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Zip | 91302-1666
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Country | US
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Telephone | 323-204-0200
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Fax | 323-204-0220
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | JOSHUA JAMES KLEINBERGS
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Credential | MSW
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Telephone | 323-204-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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