Provider Demographics
NPI:1073659967
Name:COMMUNITY SOLUTIONS, INC.
Entity Type:Organization
Organization Name:COMMUNITY SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:PROVOST
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:860-539-7745
Mailing Address - Street 1:175 ADDISON RD STE 3
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-2179
Mailing Address - Country:US
Mailing Address - Phone:860-539-7745
Mailing Address - Fax:860-683-7181
Practice Address - Street 1:546 W HAMILTON ST
Practice Address - Street 2:SUITE 205
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18101-1503
Practice Address - Country:US
Practice Address - Phone:610-435-3343
Practice Address - Fax:610-435-7211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101500041 0001Medicaid
PA1015000410002Medicaid