| Community Support Services, Inc. | |
|
5540 W Glendale Ave Ste 102 Glendale AZ 85301-2550 | |
| (480) 629-5994 | |
| (480) 629-5996 |
| Full Name | Community Support Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5540 W Glendale Ave Ste 102, Glendale, Arizona |
| Authorized Official Name and Position | Arlette Itami (PRESIDENT/CEO) |
| Authorized Official Contact | 4806295994 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Support Services, Inc. 10645 N Tatum Blvd Phoenix AZ 85028-3068 Ph: (602) 309-4210 | Community Support Services, Inc. 5540 W Glendale Ave Ste 102 Glendale AZ 85301-2550 Ph: (480) 629-5994 |
| NPI Number | 1093246340 |
|---|---|
| Provider Enumeration Date | 03/27/2017 |
| Last Update Date | 03/29/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093246340 | NPI | - | NPPES |
| 249529 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | OTC8459 (Arizona) | Primary |
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