Provider Demographics
NPI:1154296960
Name:COMMUNITY LIVING AND SUPPORT SERVICES, LLC
Entity type:Organization
Organization Name:COMMUNITY LIVING AND SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERNESSIA
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-202-7015
Mailing Address - Street 1:2687 MUNJACK CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-1729
Mailing Address - Country:US
Mailing Address - Phone:973-202-7015
Mailing Address - Fax:
Practice Address - Street 1:2687 MUNJACK CT
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-1729
Practice Address - Country:US
Practice Address - Phone:973-202-7015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child