Provider Demographics
NPI:1700372232
Name:CHILD COMMUNITY SERVICES
Entity Type:Organization
Organization Name:CHILD COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TALBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-440-6445
Mailing Address - Street 1:5390 N ACADEMY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4064
Mailing Address - Country:US
Mailing Address - Phone:719-440-6445
Mailing Address - Fax:719-374-5907
Practice Address - Street 1:5390 N ACADEMY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4064
Practice Address - Country:US
Practice Address - Phone:719-440-6445
Practice Address - Fax:719-374-5907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000163300Medicaid