Provider Demographics
NPI:1144578816
Name:COLLEGE COMMUNITY SERVICES
Entity Type:Organization
Organization Name:COLLEGE COMMUNITY SERVICES
Other - Org Name:ADAS CCS CALWORKS WESTMINSTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF STATE OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:GINTER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CBCS
Authorized Official - Phone:657-465-9497
Mailing Address - Street 1:8337 TELEGRAPH RD STE 115
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-4940
Mailing Address - Country:US
Mailing Address - Phone:562-467-5440
Mailing Address - Fax:562-467-5553
Practice Address - Street 1:13950 MILTON AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-2900
Practice Address - Country:US
Practice Address - Phone:714-793-1290
Practice Address - Fax:714-793-1267
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROVIDENCE COMMUNITY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-28
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health