Intrust Community Services

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

INTRUST COMMUNITY SERVICES

Practice address

1521 Sunny Glen St
Fort Worth, TX 76134-4853

Phone

(817) 333-4038

NPI assigned

Jan 7, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Tommie Nell DavisNPI 1689811135

Title

Director

Phone

(817) 333-4038

Specialties & licenses 1

Addresses

Other names 1

• ICS Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tommie Nell Davis

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Fort Worth, TX
  • NPI 1689811135

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD (past) Authorized official

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231286400000",
    "number": "1649417031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6691",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761150691",
            "telephone_number": "817-333-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 SUNNY GLEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761344853",
            "telephone_number": "817-333-4038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTRUST COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "TOMMIE",
        "authorized_official_middle_name": "NELL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-333-4038",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; 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.