Provider Demographics
NPI:1033687975
Name:COMMUNITY FAMILY SUPPORT SERVICES
Entity Type:Organization
Organization Name:COMMUNITY FAMILY SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:YAKEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-446-0955
Mailing Address - Street 1:12500 SHAKER BLVD APT 601
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2050
Mailing Address - Country:US
Mailing Address - Phone:216-446-0955
Mailing Address - Fax:
Practice Address - Street 1:12500 SHAKER BLVD APT 601
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-2050
Practice Address - Country:US
Practice Address - Phone:216-446-0955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty