Provider Demographics
NPI:1851647804
Name:COMMUNITY SOLUTIONS, INC.
Entity Type:Organization
Organization Name:COMMUNITY SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:PROVOST
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:860-539-7745
Mailing Address - Street 1:175 ADDISON RD STE 3
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-2179
Mailing Address - Country:US
Mailing Address - Phone:860-539-7745
Mailing Address - Fax:860-683-7199
Practice Address - Street 1:175 ADDISON RD STE 3
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-2179
Practice Address - Country:US
Practice Address - Phone:186-068-3710
Practice Address - Fax:860-683-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1659522910Medicaid
LA1104067255Medicaid
LA1740431865Medicaid
PA101500041002Medicaid