Provider Demographics
NPI:1134672017
Name:COMMUNITY SOLUTIONS, LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:COMMUNITY SOLUTIONS, LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:URSICH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:303-834-9369
Mailing Address - Street 1:219 E RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-3134
Mailing Address - Country:US
Mailing Address - Phone:303-834-9369
Mailing Address - Fax:303-834-9396
Practice Address - Street 1:219 E RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3134
Practice Address - Country:US
Practice Address - Phone:303-834-9369
Practice Address - Fax:303-834-9396
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY SOLUTIONS, LIMITED LIABILITY COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-27
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1771-02101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty