Provider Demographics
NPI:1710543178
Name:COMMUNITY CRISIS SERVICES, INC
Entity Type:Organization
Organization Name:COMMUNITY CRISIS SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-322-8778
Mailing Address - Street 1:PO BOX 149
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-0149
Mailing Address - Country:US
Mailing Address - Phone:301-322-8778
Mailing Address - Fax:
Practice Address - Street 1:3601 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:MD
Practice Address - Zip Code:20722-1300
Practice Address - Country:US
Practice Address - Phone:301-322-8778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare