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Cg-dsa, Llc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Crawfordsville, Indiana
NPI 1154340396

Cg-dsa, Llc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Fort Worth, IN. Cg-dsa, Llc practices in Crawfordsville, IN. The NPI Number for Cg-dsa, Llc is 1154340396 and holds a License No. 0683I0001JN08 (Indiana).

The current practice location address for Cg-dsa, Llc is 1313 Homewood Drive, Crawfordsville, IN and can be reached out via phone at 765-362-0905. You can also correspond with Cg-dsa, Llc through the mailing address at 4800 OVERTON PLAZA, FORT WORTH, TX - 76109-4435 (mailing address contact number: 800-299-5161).

Location: 1313 Homewood Drive, Crawfordsville, IN, 76109-4435
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1154340396
Provider Name
Cg-dsa, Llc
Credential
Provider Entity Type
Organization
Address
1313 Homewood Drive, Crawfordsville, IN, 76109-4435
Phone Number
765-362-0905
Fax Number
Provider Enumeration Date
07/19/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1313 Homewood Drive
City
Crawfordsville
State
Indiana
Zip
47933-3341
Phone Number
765-362-0905
Fax Number
person
Provider Business Mailing Address Details
Address
1313 Homewood Drive
City
Crawfordsville
State
Indiana
Zip
47933-3341
Phone Number
765-362-0905
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
0683I0002JN08 (Indiana)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
0683I0001JN08 (Indiana)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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