Provider Demographics
NPI:1922215466
Name:CONSUMER SUPPORT SERVICES, INC.
Entity Type:Organization
Organization Name:CONSUMER SUPPORT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RUBINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:740-788-8257
Mailing Address - Street 1:2040 CHERRY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1105
Mailing Address - Country:US
Mailing Address - Phone:740-788-8257
Mailing Address - Fax:740-788-8263
Practice Address - Street 1:2040 CHERRY VALLEY RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1105
Practice Address - Country:US
Practice Address - Phone:740-788-8257
Practice Address - Fax:740-788-8263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4500589251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4500589Medicaid