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General NPI Number Information
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NPI Number | 1669448544
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Entity Type | Organization
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Legal Business Name | COMMUNITY COUNSELING SERVICES, INC.
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 2458 STETZER RD
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City | BUCYRUS
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State | OH
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Zip | 44820-2066
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Country | US
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Telephone | 419-562-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 2458 STETZER RD PO BOX 765
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City | BUCYRUS
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State | OH
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Zip | 44820-2066
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Country | US
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Telephone | 419-562-2000
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | MR. PAUL E SIPES
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Credential | CPA
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Telephone | 419-562-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 0177
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 0177
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 0177
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1057
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License Number State | OH
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