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General NPI Number Information
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NPI Number | 1528197662
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Entity Type | Organization
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Legal Business Name | COLLEGE COMMUNITY SERVICES
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 2001 E 4TH ST STE 116
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City | SANTA ANA
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State | CA
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Zip | 92705
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Country | US
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Telephone | 714-824-8150
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Fax | 714-824-8151
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Provider Business Mailing Address
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Address Line | 8337 TELEGRAPH RD STE 115
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City | PICO RIVERA
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State | CA
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Zip | 90660-4940
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Country | US
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Telephone | 562-467-5440
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Fax | 562-467-5553
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Authorized Official
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Title or Position | DIRECTOR OF STATE OPERATIONS
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Name | TRACY GINTER
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Credential | MBA, CBCS
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Telephone | 657-465-9497
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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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