Provider Demographics
NPI:1124835186
Name:COMMUNITY SUPPORT INITIATIVE (CSI), CORPORATION
Entity type:Organization
Organization Name:COMMUNITY SUPPORT INITIATIVE (CSI), CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERIDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTEVES
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:916-892-5187
Mailing Address - Street 1:2251 FLORIN RD STE 96
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-4483
Mailing Address - Country:US
Mailing Address - Phone:916-400-3102
Mailing Address - Fax:916-400-3261
Practice Address - Street 1:2251 FLORIN RD STE 96
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-4483
Practice Address - Country:US
Practice Address - Phone:916-400-3102
Practice Address - Fax:916-400-3261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage
No251V00000XAgenciesVoluntary or Charitable