Provider Demographics
NPI:1376120568
Name:COMMUNITY SUPPORT NETWORK INC
Entity Type:Organization
Organization Name:COMMUNITY SUPPORT NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUTHIER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, MBA
Authorized Official - Phone:603-229-1982
Mailing Address - Street 1:10 FERRY ST STE 309
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5081
Mailing Address - Country:US
Mailing Address - Phone:603-229-1982
Mailing Address - Fax:
Practice Address - Street 1:10 FERRY ST STE 309
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5081
Practice Address - Country:US
Practice Address - Phone:603-229-1982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health