1114440955 NPI number — D&S RESIDENTIAL SERVICES, LP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114440955 NPI number — D&S RESIDENTIAL SERVICES, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
D&S RESIDENTIAL SERVICES, LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HUNTSVILLE COMMUNITY RESIDENCE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114440955
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8911 N. CAPITAL OF TEXAS HWY.
Provider Second Line Business Mailing Address:
BLDG. 1, STE. 1300
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78759
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-327-2325
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
63 STATE HIGHWAY 75 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77320-3863
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-327-2325
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2017

Additional Information

Authorized Official

Authorized Official Last Name:
COHEN
Authorized Official First Name:
BRETT
Authorized Official Middle Name:
IAN
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
800-388-5150

Provider Taxonomy Codes

  • Taxonomy code: 315P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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