Provider Demographics
NPI:1023369915
Name:COMMUNITY SUPPORT SYSTEMS CFC 20
Entity Type:Organization
Organization Name:COMMUNITY SUPPORT SYSTEMS CFC 20
Other - Org Name:CHILD AND FAMILY CONNECTIONS #20
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-705-4300
Mailing Address - Street 1:1901 S 4TH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-4162
Mailing Address - Country:US
Mailing Address - Phone:217-705-4300
Mailing Address - Fax:217-347-5437
Practice Address - Street 1:1901 S 4TH ST STE 209
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-4162
Practice Address - Country:US
Practice Address - Phone:217-705-4300
Practice Address - Fax:217-347-5437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency