Organization Active NPI

CG-Dsa, LLC

  • Intellectual Disabilities Intermediate Care Facility
  • Angola, IN
National Provider Identifier
1801534177
Registry record updated May 25, 2022
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
1102 W Mill St
Angola, IN 46703-1344
Phone
(260) 833-4208
NPI assigned
May 25, 2022
Last updated
May 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Authorized official

Name
Brandi Turner
Title
Licensing and Contracts Coordinator
Phone
(800) 299-5161

Specialties & licenses 1

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

Addresses

Primary practice location

1102 W Mill St
Angola, IN 46703-1344

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

Other organizations with this tax ID 40

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

View all 40

Locations

1102 W Mill St
Angola, IN 46703
Phone (260) 665-7681

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1801534177",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 W MILL ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467031344",
            "telephone_number": "260-833-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CG-DSA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "LICENSING AND CONTRACTS COORDINATOR",
        "authorized_official_telephone_number": "800-299-5161"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.