Provider Demographics
NPI:1093882888
Name:COMMUNITY BASED SERVICES, INC.
Entity Type:Organization
Organization Name:COMMUNITY BASED SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGOT
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-277-4771
Mailing Address - Street 1:3 FIELDS LN
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-1001
Mailing Address - Country:US
Mailing Address - Phone:914-277-4771
Mailing Address - Fax:914-277-8956
Practice Address - Street 1:4 LOWER SHAD RD
Practice Address - Street 2:
Practice Address - City:POUND RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10576-2215
Practice Address - Country:US
Practice Address - Phone:914-277-4771
Practice Address - Fax:914-277-8956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00577711310500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness