Provider Demographics
NPI:1376636068
Name:COMMUNITY CARE SERVICES, INC
Entity type:Organization
Organization Name:COMMUNITY CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-821-7777
Mailing Address - Street 1:70 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780
Mailing Address - Country:US
Mailing Address - Phone:508-821-7777
Mailing Address - Fax:508-880-6155
Practice Address - Street 1:70 MAIN STREET
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780
Practice Address - Country:US
Practice Address - Phone:508-821-7777
Practice Address - Fax:508-880-6155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA0600X
MA4426261QM0801X
MA1475210320800000X
MA1474910320800000X
MA1475604323P00000X
MA14756403245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Not Answered320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Not Answered323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Not Answered3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1309161Medicaid
MA1307223Medicaid
MA1901249Medicaid
RIVC16549OtherDCYF
RIVC16549OtherDCYF