MEDICARE: COMMUNITY FIRST SUPPORT SERVICES

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	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1578413688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY FIRST SUPPORT SERVICES

Provider Business Mailing Address
First Line	:	175 LITTLE SORREL DR
Second Line	:
City	:	MIDDLETOWN
State	:	VA
Zip	:	22645-4015
Country	:	US
Telephone Number	:	540-202-7910
Fax Number	:	240-778-2233

Provider Business Practice Location Address
First Line	:	175 LITTLE SORREL DR
Second Line	:
City	:	MIDDLETOWN
State	:	VA
Zip	:	22645-4015
Country	:	US
Telephone Number	:	540-202-7910
Fax Number	:	240-778-2233

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	MR. ALEXANDER KOILA NGATI
Credential	:	APRN
Telephone Number	:	240-888-0902

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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Directions to “COMMUNITY FIRST SUPPORT SERVICES ” Practice Location

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