Organization
COMMUNITY SUPPPORT NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RITA LARSON (DIRECTOR OF SOCIAL REHABILITATION)
(707) 575-0979
Entity
Organization
Contact information
Practice address
634 PRESSLEY ST, SANTA ROSA, CA 95404-5526
(707) 573-6955
(707) 543-8176
Mailing address
1410 GUERNEVILLE RD, 14, SANTA ROSA, CA 95403-7231
(707) 575-0979
(707) 573-6968
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
03/30/2007
Last updated
06/15/2012
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