Organization Active NPI

CG-Dsa, LLC

  • Intellectual Disabilities Intermediate Care Facility
  • Anderson, IN
National Provider Identifier
1417530940
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
CG-DSA, LLC
Practice address
4918 Michael St
Anderson, IN 46013-1327
Phone
(765) 649-4247
NPI assigned
May 3, 2021
Organization subpart
Yes
Parent organization
CG-DSA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anna Todd
Title
Operations Business Manager
Phone
(800) 299-5161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

4918 Michael St
Anderson, IN 46013-1327

Mailing address

4800 Overton PLZ Ste 440
Fort Worth, TX 76109-4435
Phone (800) 299-5161

National Provider Directory

National Provider Directory
Tax ID family
CG-Dsa LLC41 organizations share this tax ID, including this one
Part of
CG-Dsa LLC

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1417530940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 OVERTON PLZ STE 440",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094435",
            "telephone_number": "800-299-5161",
            "fax_number": "817-447-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4918 MICHAEL ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460131327",
            "telephone_number": "765-649-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CG-DSA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CG-DSA, LLC",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "TODD",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "OPERATIONS BUSINESS MANAGER",
        "authorized_official_telephone_number": "800-299-5161"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.