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General NPI Number Information
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NPI Number | 1487873147
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Entity Type | Organization
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Legal Business Name | COMMUNITY SUPPORT SPECIALISTS, INC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 05/08/2009
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Provider Practice Location Address
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Address Line | 7921 BULLARD AVE
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City | NEW ORLEANS
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State | LA
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Zip | 70128-1197
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Country | US
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Telephone | 504-245-5757
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Fax | 866-902-2182
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Provider Business Mailing Address
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Address Line | PO BOX 870462
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City | NEW ORLEANS
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State | LA
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Zip | 70187-0462
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Country | US
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Telephone | 504-245-5757
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Fax | 866-902-2182
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. LAKISHA HALL
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Credential |
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Telephone | 504-245-5757
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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 | 11948
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License Number State | LA
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