MEDICARE: COMMUNITY RESOURCE SOLUTIONS LLC

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	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1629204300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY RESOURCE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	4641 S CARROLLTON AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-6024
Country	:	US
Telephone Number	:	919-638-6392
Fax Number	:	336-896-2206

Provider Business Practice Location Address
First Line	:	4631 S CARROLLTON AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-6024
Country	:	US
Telephone Number	:	919-638-6392
Fax Number	:	336-896-2206

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MR. WARRICK STEWART
Credential	:
Telephone Number	:	919-638-6392

Provider Enumeration Date	:	06/08/2009
Last Update Date	:	06/08/2009

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