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General NPI Number Information
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NPI Number | 1487637724
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Entity Type | Organization
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Legal Business Name | COMMUNITY SUBSTANCE ABUSE CENTERS, INC.
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 55 FISHFRY ST
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City | HARTFORD
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State | CT
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Zip | 06120-1203
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Country | US
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Telephone | 860-247-8300
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Fax | 860-548-7325
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Provider Business Mailing Address
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Address Line | 1720 LAKEPOINTE DR STE 117
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City | LEWISVILLE
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State | TX
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Zip | 75057-6425
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Country | US
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Telephone | 214-379-3300
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Fax | 214-853-9018
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Authorized Official
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Title or Position | VP, TREASURER
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Name | BRUCE JARVIE
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Credential |
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Telephone | 214-379-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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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 | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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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 | 261QM2800X
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Taxonomy Name | Methadone Clinic
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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