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General NPI Number Information
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NPI Number | 1841662889
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Entity Type | Organization
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Legal Business Name | COMMUNITY SOLUTIONS, INC
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Dates
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Enumeration Date | 10/29/2015
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 420 21ST AVE SUITE 113
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City | LONGMONT
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State | CO
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Zip | 80501-1441
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Country | US
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Telephone | 303-834-9369
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Fax | 303-834-9396
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Provider Business Mailing Address
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Address Line | 420 21ST AVE SUITE 113
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City | LONGMONT
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State | CO
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Zip | 80501-1441
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Country | US
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Telephone | 303-834-9369
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Fax | 303-834-9396
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MARY ANN URSICH
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Credential | LAC, LMFT
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Telephone | 720-436-7537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1771-01
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License Number State | CO
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Taxonomy #2
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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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