CG-DSA LLC NPI 1437186715

NPI Information

  • NPI: 1437186715
  • Provider Name: CG-DSA, LLC
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Address: 2228 VAN BUSKIRK ROAD
    ANDERSON, IN
    ZIP 46011
  • Phone: (765) 649-4247

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NPI Details

CG-DSA, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Anderson, 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 1437186715. The provider is registered as an organization entity type.

The provider's business location address is:

2228 VAN BUSKIRK ROAD
ANDERSON, IN
ZIP 46011-043
Phone: (765) 649-4247
Fax: (765) 642-8512

The provider's authorized official is Anna Todd .
The authorized official title is Operations Business Manager and has the following contact phone number (800) 229-5161.

The enumeration date for this NPI number is 6/26/2006 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 Taxonomy Specialization License Number License State Primary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100245100CMEDICAIDINDIANA

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: 3/30/2025

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