Organization
COMMUNITY SUPPORT SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PRISCILLA FAITH COY-MONAHAN (CEO)
(425) 672-8787
Entity
Organization
Contact information
Practice address
407 HOWELL WAY, EDMONDS, WA 98020-4186
(425) 672-8787
(245) 670-1640
Mailing address
PO BOX 1237, EDMONDS, WA 98020-1237
(425) 672-8787
(425) 670-1640
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251T00000X
PACE Provider Organization
—
—
251X00000X
Supports Brokerage Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
IHS.FS.60304414
WA
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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