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General NPI Number Information
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NPI Number | 1780192989
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Entity Type | Organization
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Legal Business Name | CHILD COMMUNITY SERVICES
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Dates
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Enumeration Date | 01/22/2018
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 2210 E LA SALLE ST # 108
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-2303
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Country | US
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Telephone | 719-440-6445
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Fax |
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Provider Business Mailing Address
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Address Line | 2210 E LA SALLE ST STE 108
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-2303
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Country | US
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Telephone | 719-440-6445
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CHRISTINE TALBOTT
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Credential |
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Telephone | 719-440-6445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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