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General NPI Number Information
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NPI Number | 1821905506
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Entity Type | Organization
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Legal Business Name | COMMUNITY SUPPORT CENTER LLC
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 14040 N CAVE CREEK RD STE 309
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City | PHOENIX
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State | AZ
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Zip | 85022-6106
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Country | US
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Telephone | 602-786-7466
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Fax |
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Provider Business Mailing Address
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Address Line | 14040 N CAVE CREEK RD STE 309
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City | PHOENIX
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State | AZ
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Zip | 85022-6106
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Country | US
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Telephone | 602-786-7466
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEREMY THRASHER
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Credential |
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Telephone | 916-501-5038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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