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General NPI Number Information
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NPI Number | 1134421696
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Entity Type | Organization
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Legal Business Name | THE COMMUNITY SUPPORTS NETWORK INC
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Dates
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Enumeration Date | 12/03/2010
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 5539 S 27TH ST STE 204
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City | LINCOLN
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State | NE
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Zip | 68512-1600
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Country | US
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Telephone | 402-435-2811
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W BROADWAY SUITE 111
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-9019
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Country | US
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Telephone | 712-242-0533
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Fax | 712-242-0534
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Authorized Official
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Title or Position | CEO
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Name | MR. BRIAN KANTER
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Credential |
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Telephone | 402-435-2134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | IA
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