CG-Dsa, LLC

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · New Palestine, IN

NPI 1467488155 · NPPES record last updated Aug 13, 2021

Key facts

NPI
1467488155
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
CG-DSA, LLC
Practice address
1757 S 600 W
New Palestine, IN 46163-9790
Phone
(317) 477-0093
Fax
(317) 348-3430
NPI assigned
Jun 24, 2006
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 40

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

View all 40

National Provider Directory

Tax ID family
CG-Dsa LLC (41 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

1757 S 600 W
New Palestine, IN 46163-9790

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
100243410CMedicaidIN

Other providers in New Palestine, IN

All providers in New Palestine, IN · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Indiana

Sources for this page

Verify at the official NPI Registry.