Provider Demographics
NPI:1093938599
Name:COMMUNITY SUPPORT CENTER, INC.
Entity type:Organization
Organization Name:COMMUNITY SUPPORT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-737-0777
Mailing Address - Street 1:PO BOX 1162
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83303-1162
Mailing Address - Country:US
Mailing Address - Phone:208-737-0777
Mailing Address - Fax:208-734-5470
Practice Address - Street 1:336 MAIN AVE S
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6423
Practice Address - Country:US
Practice Address - Phone:208-737-0777
Practice Address - Fax:208-734-5470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)