Provider Demographics
NPI:1497947188
Name:CLIENT DIRECTED SERVICES, LLC
Entity Type:Organization
Organization Name:CLIENT DIRECTED SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:QP
Authorized Official - Phone:704-545-0407
Mailing Address - Street 1:PO BOX 691778
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-7030
Mailing Address - Country:US
Mailing Address - Phone:704-545-0407
Mailing Address - Fax:704-545-9395
Practice Address - Street 1:4410 LAUREL TWIG CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-9002
Practice Address - Country:US
Practice Address - Phone:704-545-0407
Practice Address - Fax:704-545-9395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services