Organization · Type 2 NPI

Community Support Network

Intellectual and/or Developmental Disabilities Residential Treatment Facility · Santa Rosa, CA

NPI number 1992828966 Active

Practice location

1550 N. Dutton Ave
Santa Rosa, CA 95401

Call (707) 573-6962 Map

Fax (707) 573-6967

Mailing address

1410 Guerneville Rd, Suite 14
Santa Rosa, CA 94503

Specialties and licenses

Taxonomy	Code	License
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary	320600000X	490111656 (CA)

Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

Other intellectual and/or developmental disabilities residential treatment facility providers in Santa Rosa

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NPI record

NPI: 1992828966
Entity type: Organization (Type 2)
Issued: Apr 6, 2007
Last updated: Jul 16, 2008
Status: Active
Subpart: Yes of Community Support Network

Other names

<unavail>
CSN Dutton · doing business as

Authorized official

Rosemary Devitt, M.A.
Director of Finance Admin.
(707) 575-0979

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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 1992828966

Community Support Network's National Provider Identifier is 1992828966, issued on Apr 6, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Santa Rosa, CA. The record was last updated on Jul 16, 2008.