Provider Demographics
NPI:1346965100
Name:COMMUNITY CARE SERVICES,LLC
Entity Type:Organization
Organization Name:COMMUNITY CARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OYEWALE
Authorized Official - Middle Name:O
Authorized Official - Last Name:OYERINDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-772-8655
Mailing Address - Street 1:15618 W PORT AU PRINCE LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-6283
Mailing Address - Country:US
Mailing Address - Phone:608-772-8655
Mailing Address - Fax:
Practice Address - Street 1:15618 W PORT AU PRINCE LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-6283
Practice Address - Country:US
Practice Address - Phone:608-772-8655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child