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COLLEGE COMMUNITY SERVICES NPI 1013122514


NPI Information

NPI: 1013122514
Provider Name: COLLEGE COMMUNITY SERVICES
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 05D2242354

Address:
16940 HIGHWAY 14 STE C-J
MOJAVE, CA
ZIP 93501
Phone: (661) 824-5020
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COLLEGE COMMUNITY SERVICES is a community behavioral health in Mojave, CA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. COLLEGE COMMUNITY SERVICES NPI is 1013122514. The provider is registered as an organization entity type.

The provider's business location address is:

16940 HIGHWAY 14 STE C-J
MOJAVE, CA
ZIP 93501-238
Phone: (661) 824-5020
Fax: (661) 824-5026

The provider's authorized official is Tracy Ginter .
The authorized official title is Director Of State Operations and has the following contact phone number (657) 465-9497.

The CLIA number assigned to this NPI record is 05D2242354 - other - sud outpatient clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/10/2007 and was last updated on 1/6/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
115AKMEDICAIDCALIFORNIA
21539MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.