Provider Demographics
NPI:1235403114
Name:COMMUNITY CARE SERVICES
Entity Type:Organization
Organization Name:COMMUNITY CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:I
Authorized Official - Credentials:BA
Authorized Official - Phone:508-822-2345
Mailing Address - Street 1:100 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2711
Mailing Address - Country:US
Mailing Address - Phone:508-822-2345
Mailing Address - Fax:508-822-5363
Practice Address - Street 1:100 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2711
Practice Address - Country:US
Practice Address - Phone:508-822-2345
Practice Address - Fax:508-822-5363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS17518236251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management