Organization
COMMUNITY SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN L HARRIS (FOUNDER)
(414) 554-4994
Entity
Organization
Contact information
Practice address
3707 W GOOD HOPE RD APT 7, MILWAUKEE, WI 53209-2362
(414) 554-4994
Mailing address
3707 W GOOD HOPE RD APT 7, MILWAUKEE, WI 53209-2362
(414) 554-4994
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407262678
—
WI
Enumeration date
04/16/2021
Last updated
04/16/2021
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