Organization · Type 2 NPI

Community Support Network

Mental Illness Community Based Residential Treatment Facility · Santa Rosa, CA

NPI number 1336349398 Active

Practice location

634 Pressley St
Santa Rosa, CA 95404-5526

Call (707) 573-6955 Map

Fax (707) 543-8176

Mailing address

1410 Guerneville Rd
Santa Rosa, CA 95403-7231

Specialties and licenses

Taxonomy	Code	License
Mental Illness Community Based Residential Treatment Facility Primary	320800000X	None listed

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

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NPI record

NPI: 1336349398
Entity type: Organization (Type 2)
Issued: Jul 18, 2007
Last updated: Jun 23, 2008
Status: Active
Subpart: Yes of Community Support Network

Other names

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CSN Opportunity House · doing business as

Authorized official

Ms. Rosemary Devitt
Program Manager
(707) 575-0979

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1336349398

Community Support Network's National Provider Identifier is 1336349398, issued on Jul 18, 2007. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Santa Rosa, CA. The record was last updated on Jun 23, 2008.