Provider Demographics
NPI:1154325645
Name:ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES
Entity Type:Organization
Organization Name:ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES
Other - Org Name:ACCESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-586-5507
Mailing Address - Street 1:913 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-3801
Mailing Address - Country:US
Mailing Address - Phone:903-586-5507
Mailing Address - Fax:903-586-4234
Practice Address - Street 1:5656 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-9641
Practice Address - Country:US
Practice Address - Phone:903-589-9000
Practice Address - Fax:903-586-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty