CG-DSA LLC NPI 1154340396

NPI Information

NPI: 1154340396
Provider Name: CG-DSA, LLC
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
1313 HOMEWOOD DRIVE
CRAWFORDSVILLE, IN
ZIP 47933
Phone: (765) 362-0905
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CG-DSA, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Crawfordsville, IN. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. CG-DSA, LLC NPI is 1154340396. The provider is registered as an organization entity type.

The provider's business location address is:

1313 HOMEWOOD DRIVE
CRAWFORDSVILLE, IN
ZIP 47933-341
Phone: (765) 362-0905

The provider's authorized official is Anna Todd .
The authorized official title is Operations Business Manager and has the following contact phone number (800) 299-5161.

The enumeration date for this NPI number is 7/19/2006 and was last updated on 8/13/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities	0683I0001JN08	INDIANA	No
2	315P00000X	Intermediate Care Facility, Intellectual Disabilities	0683I0002JN08	INDIANA	No
3	315P00000X	Intermediate Care Facility, Intellectual Disabilities	0683I0003JN08	INDIANA	No
4	315P00000X	Intermediate Care Facility, Intellectual Disabilities	0683I0004JN08	INDIANA	No
5	315P00000X	Intermediate Care Facility, Intellectual Disabilities	0683I0005JN08	INDIANA	No
6	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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