Provider Demographics
NPI:1033648555
Name:D&S RESIDENTIAL SERVICES, LP
Entity Type:Organization
Organization Name:D&S RESIDENTIAL SERVICES, LP
Other - Org Name:BASTROP COMMUNITY RESIDENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP & SR.ASST GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:RODENBERG-ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-836-2234
Mailing Address - Street 1:8911 N. CAPITAL OF TEXAS HWY., BLDG. 1
Mailing Address - Street 2:STE. 1300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-327-2325
Mailing Address - Fax:
Practice Address - Street 1:133 PLUM ST
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-6755
Practice Address - Country:US
Practice Address - Phone:512-321-3316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D&S RESIDENTIAL HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-08
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities