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General NPI Number Information
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NPI Number | 1710543178
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Entity Type | Organization
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Legal Business Name | COMMUNITY CRISIS SERVICES, INC
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Dates
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Enumeration Date | 05/11/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 3601 TAYLOR ST
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City | BRENTWOOD
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State | MD
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Zip | 20722-1300
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Country | US
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Telephone | 301-322-8778
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 149
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City | HYATTSVILLE
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State | MD
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Zip | 20781-0149
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Country | US
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Telephone | 301-322-8778
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Fax |
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Authorized Official
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Title or Position | CHIEF CLINICAL OFFICER
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Name | DR. ANNE CORNELL
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Credential | PHD
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Telephone | 301-322-8778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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