Organization
COMMUNITY SUPPORT NETWORK
Active
Parent organization
COMMUNITY SUPPORT NETWORK
Other names
CSN Dutton
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY SUPPORT NETWORK
Authorized official
ROSEMARY DEVITT M.A. (DIRECTOR OF FINANCE ADMIN.)
(707) 575-0979
Entity
Organization
Contact information
Practice address
1550 N. DUTTON AVE, SANTA ROSA, CA 95401
(707) 573-6962
(707) 573-6967
Mailing address
1410 GUERNEVILLE RD, SUITE 14, SANTA ROSA, CA 94503
(707) 575-0979
(707) 573-6968
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
490111656
CA
Other
Enumeration date
04/06/2007
Last updated
07/16/2008
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