Provider Demographics
NPI:1275677940
Name:COMMUNITY SPECIALIZED SERVICES, INC.
Entity Type:Organization
Organization Name:COMMUNITY SPECIALIZED SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CASTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:704-795-7600
Mailing Address - Street 1:PO BOX 1298
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28026-1298
Mailing Address - Country:US
Mailing Address - Phone:704-795-7600
Mailing Address - Fax:704-795-7601
Practice Address - Street 1:15 SPENCER AVE NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4316
Practice Address - Country:US
Practice Address - Phone:704-795-7600
Practice Address - Fax:704-795-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 253J00000X, 385HR2055X
NC125322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No251S00000XAgenciesCommunity/Behavioral Health
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child