Provider Demographics
NPI:1619049202
Name:COMMUNITY BASED SERVICES, INC.
Entity Type:Organization
Organization Name:COMMUNITY BASED SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STASIAK
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:914-277-4771
Mailing Address - Street 1:3 FIELDS LN
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-1001
Mailing Address - Country:US
Mailing Address - Phone:914-277-4771
Mailing Address - Fax:914-277-8956
Practice Address - Street 1:2466 BROAD ST
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-3819
Practice Address - Country:US
Practice Address - Phone:914-245-3088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00739102315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities