Provider Demographics
NPI:1457171340
Name:COMMUNITY SERVICES CONSORTIUM
Entity type:Organization
Organization Name:COMMUNITY SERVICES CONSORTIUM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-704-7621
Mailing Address - Street 1:250 BROADALBIN ST SW STE 2A
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2299
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 BROADALBIN ST SW STE 2A
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2299
Practice Address - Country:US
Practice Address - Phone:541-928-6335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management