Provider Demographics
NPI:1275039315
Name:CONSUMER SUPPORT SERVICES, INC.
Entity Type:Organization
Organization Name:CONSUMER SUPPORT SERVICES, INC.
Other - Org Name:CSS EL CAMINO DRIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SWICKARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-899-3790
Mailing Address - Street 1:3660 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-4962
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3154 EL CAMINO DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-1318
Practice Address - Country:US
Practice Address - Phone:614-889-3785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONSUMER SUPPORT SERVICICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2555462Medicaid