Provider Demographics
NPI:1790256766
Name:COLLEGE COMMUNITY SERVICES
Entity Type:Organization
Organization Name:COLLEGE COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF STATE OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:GINTER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CBCS
Authorized Official - Phone:657-465-9497
Mailing Address - Street 1:8337 TELEGRAPH RD STE 115
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-4940
Mailing Address - Country:US
Mailing Address - Phone:562-467-5440
Mailing Address - Fax:562-467-5553
Practice Address - Street 1:928 F ST
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280-2040
Practice Address - Country:US
Practice Address - Phone:562-467-5440
Practice Address - Fax:562-467-5553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health