Provider Demographics
NPI:1376864363
Name:ELLIS COUNTY COMMUNITY SERVICES INC
Entity Type:Organization
Organization Name:ELLIS COUNTY COMMUNITY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-291-2929
Mailing Address - Street 1:625 JEALOUSE WAY
Mailing Address - Street 2:SUITE 116
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2577
Mailing Address - Country:US
Mailing Address - Phone:972-291-2929
Mailing Address - Fax:972-291-2949
Practice Address - Street 1:625 JEALOUSE WAY
Practice Address - Street 2:SUITE 116
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2577
Practice Address - Country:US
Practice Address - Phone:972-291-2929
Practice Address - Fax:972-291-2949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty