Provider Demographics
NPI:1053465492
Name:CROSS PLAINS COMMUNITY PARTNER, INC
Entity Type:Organization
Organization Name:CROSS PLAINS COMMUNITY PARTNER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CONWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-278-8143
Mailing Address - Street 1:2738 UNDERWOOD RD NE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-7471
Mailing Address - Country:US
Mailing Address - Phone:706-278-8143
Mailing Address - Fax:706-272-7648
Practice Address - Street 1:2738 UNDERWOOD RD NE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-7471
Practice Address - Country:US
Practice Address - Phone:706-278-8143
Practice Address - Fax:706-272-7648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services