Organization
COMMUNITY SUPPORT NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALLISON BALL (PROGRAM MANAGER)
(707) 765-0102
Entity
Organization
Contact information
Practice address
21 FAYE CT, PETALUMA, CA 94952-2202
(707) 765-0102
(707) 765-0124
Mailing address
21 FAYE CT, PETALUMA, CA 94952-2202
(707) 765-0102
(707) 765-0124
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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