Provider Demographics
NPI:1437400751
Name:COMMUNITY RESIDENTIAL SERVICES, INC.
Entity Type:Organization
Organization Name:COMMUNITY RESIDENTIAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGRATH
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:412-298-7778
Mailing Address - Street 1:1360 1/2 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-1970
Mailing Address - Country:US
Mailing Address - Phone:724-258-2934
Mailing Address - Fax:724-258-2936
Practice Address - Street 1:1360 1/2 4TH ST
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-1970
Practice Address - Country:US
Practice Address - Phone:724-258-2934
Practice Address - Fax:724-258-2936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4339013104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness