Organization
COMMUNITY SOCIAL INTEGRATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CURTIS LAMONT GIBSON (OWNER)
(203) 980-5479
Entity
Organization
Contact information
Practice address
2666 STATE ST STE 6, HAMDEN, CT 06517-2232
(203) 287-1543
(203) 407-1625
Mailing address
2666 STATE ST STE 6, HAMDEN, CT 06517-2232
(203) 287-1543
(203) 407-1625
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003212605A
—
GA
05
—
003212605B
—
GA
Enumeration date
02/24/2020
Last updated
02/24/2020
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