Organization
COMMUNITY SUPPORT NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE WHITE (PRESIDENT)
(727) 321-7788
Entity
Organization
Contact information
Practice address
2749 1ST AVE N, ST PETERSBURG, FL 33713-8723
(727) 321-7788
(727) 327-7187
Mailing address
2749 1ST AVE N, ST PETERSBURG, FL 33713-8723
(727) 321-7788
(727) 327-7187
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
671069768
—
FL
05
—
671069796
—
FL
05
—
671069798
—
FL
Enumeration date
03/28/2011
Last updated
03/28/2011
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