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Organization
CG-DSA, LLC
Active
Organization
CG-DSA, LLC
Active
Parent organization
CG-DSA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CG-DSA, LLC
Authorized official
ANNA TODD (OPERATIONS BUSINESS MANAGER)
(800) 299-5161
Entity
Organization
Contact information
Practice address
1435 CONGRESS ST, MIDDLETOWN, IN 47356-9323
(765) 649-4247
Mailing address
4800 OVERTON PLZ STE 440, FORT WORTH, TX 76109-4435
(800) 299-5161
(817) 447-3033
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
05/03/2021
Last updated
05/03/2021
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