Organization
COMMUNITY SUPPORT SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARLETTE ITAMI (PRESIDENT/CEO)
(480) 629-5994
Entity
Organization
Contact information
Practice address
5062 N 19TH AVE STE 102, PHOENIX, AZ 85015-3225
(480) 629-5994
Mailing address
10645 N TATUM BLVD, PHOENIX, AZ 85028-3068
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH-3873
AZ
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247316
—
AZ
Enumeration date
12/01/2011
Last updated
06/20/2019
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