MEDICARE: COMMUNITY SUPPORT SPECIALISTS, 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	251X00000X	Supports Brokerage Agency	11947	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831374370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY SUPPORT SPECIALISTS, INC

Provider Business Mailing Address
First Line	:	PO BOX 870462
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70187-0462
Country	:	US
Telephone Number	:	504-245-5757
Fax Number	:	866-902-2182

Provider Business Practice Location Address
First Line	:	7921 BULLARD AVE
Second Line	:	UNIT 2B
City	:	NEW ORLEANS
State	:	LA
Zip	:	70128-1197
Country	:	US
Telephone Number	:	504-245-5757
Fax Number	:	866-902-2182

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	LAKISHA HALL
Credential	:
Telephone Number	:	504-245-5757

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	05/08/2009

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