Organization
COMMUNITY SUPPORT SYSTEMS, INC.
Active
Other names
Hope House
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN WOLD MSW, LSW, CPRP (DIRECTOR)
(218) 444-6748
Entity
Organization
Contact information
Practice address
2014 7TH ST SE, BEMIDJI, MN 56601-5051
(218) 444-6748
(218) 444-8664
Mailing address
PO BOX 1097, BEMIDJI, MN 56619-1097
(218) 444-6748
(218) 444-8664
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188559600
—
MN
05
—
795355100
—
MN
01
—
7H034CO
BLUE CROSS/BLUE SHIELD
MN
01
—
85D48HO
BLUE CROSS/BLUE SHIELD
MN
Enumeration date
04/25/2008
Last updated
01/04/2011
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