MEDICARE: COMMUNITY SOLUTIONS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	46702	RI

General Provider Information

NPI Number	:	1508080136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY SOLUTIONS, INC.

Provider Business Mailing Address
First Line	:	175 ADDISON RD STE 3
Second Line	:
City	:	WINDSOR
State	:	CT
Zip	:	06095-2179
Country	:	US
Telephone Number	:	860-539-7745
Fax Number	:	860-683-7181

Provider Business Practice Location Address
First Line	:	344 HOPKINS HILL RD
Second Line	:	COVENTRY HOUSE
City	:	COVENTRY
State	:	RI
Zip	:	02816-6332
Country	:	US
Telephone Number	:	401-821-1851
Fax Number	:	401-828-4706

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MR. NATHAN RUSSELL PROVOST
Credential	:	CPA
Telephone Number	:	860-539-7745

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	11/01/2023

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Directions to “COMMUNITY SOLUTIONS, INC. ” Practice Location

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