Provider Demographics
NPI:1295228559
Name:COMMUNITY SOLUTIONS FOR CHILDREN, FAMILIES, AND INDIVIDUALS
Entity Type:Organization
Organization Name:COMMUNITY SOLUTIONS FOR CHILDREN, FAMILIES, AND INDIVIDUALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF QA & COMPLIANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MADIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-846-4770
Mailing Address - Street 1:9015 MURRAY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-3617
Mailing Address - Country:US
Mailing Address - Phone:408-842-7138
Mailing Address - Fax:408-842-0757
Practice Address - Street 1:201 N 1ST STREET
Practice Address - Street 2:SUITES 210 AND 720
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95113-9998
Practice Address - Country:US
Practice Address - Phone:408-882-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY SOLUTIONS FOR CHILDREN, FAMILIES, AND INDIVIDUALS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-12
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1639218258OtherNPI OF PARENT