Provider Demographics
NPI:1083019202
Name:COMMUNITY SUPPORT SERVICES OF TEXAS
Entity Type:Organization
Organization Name:COMMUNITY SUPPORT SERVICES OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANESE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-839-4755
Mailing Address - Street 1:4000 SIGMA RD
Mailing Address - Street 2:APT 9403
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75244-8115
Mailing Address - Country:US
Mailing Address - Phone:414-839-4755
Mailing Address - Fax:888-320-7479
Practice Address - Street 1:4000 SIGMA RD
Practice Address - Street 2:APT 9403
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-8115
Practice Address - Country:US
Practice Address - Phone:414-839-4755
Practice Address - Fax:888-320-7479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty