Provider Demographics
NPI:1255916094
Name:COMMUNITY ASSISTANCE SUPPORT SERVICES
Entity type:Organization
Organization Name:COMMUNITY ASSISTANCE SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-285-9186
Mailing Address - Street 1:3399 OAKHAM MOUNT DR
Mailing Address - Street 2:
Mailing Address - City:TRIANGLE
Mailing Address - State:VA
Mailing Address - Zip Code:22172-2343
Mailing Address - Country:US
Mailing Address - Phone:571-285-9186
Mailing Address - Fax:
Practice Address - Street 1:3399 OAKHAM MOUNT DR
Practice Address - Street 2:
Practice Address - City:TRIANGLE
Practice Address - State:VA
Practice Address - Zip Code:22172-2343
Practice Address - Country:US
Practice Address - Phone:571-285-9186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging