Provider Demographics
NPI:1215041991
Name:COMMUNITY SUPPORT SYSTEMS
Entity Type:Organization
Organization Name:COMMUNITY SUPPORT SYSTEMS
Other - Org Name:ARC COMMUNITY SUPPORT SYSTEMS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:KISTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-705-4298
Mailing Address - Street 1:618 W. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:TEUTOPOLIS
Mailing Address - State:IL
Mailing Address - Zip Code:62467
Mailing Address - Country:US
Mailing Address - Phone:217-705-4300
Mailing Address - Fax:
Practice Address - Street 1:618 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TEUTOPOLIS
Practice Address - State:IL
Practice Address - Zip Code:62467-1210
Practice Address - Country:US
Practice Address - Phone:217-705-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health