Provider Demographics
NPI:1215436118
Name:CONSISTENT SUPPORTS COORDINATION, LLC
Entity type:Organization
Organization Name:CONSISTENT SUPPORTS COORDINATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-757-0283
Mailing Address - Street 1:923 HADDONFIELD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2752
Mailing Address - Country:US
Mailing Address - Phone:724-757-0283
Mailing Address - Fax:
Practice Address - Street 1:923 HADDONFIELD RD STE 300
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2752
Practice Address - Country:US
Practice Address - Phone:865-324-8260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0666378Medicaid