Provider Demographics
NPI:1528581220
Name:D&S RESIDENTIAL SERVICES, LP
Entity Type:Organization
Organization Name:D&S RESIDENTIAL SERVICES, LP
Other - Org Name:HOLLY ST. COMMUNITY RESIDENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:IAN
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-388-5150
Mailing Address - Street 1:8911 N. CAPITAL OF TEXAS HWY.
Mailing Address - Street 2:BLDG. 1, 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 1:1420 HOLLY ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:TX
Practice Address - Zip Code:77575-3118
Practice Address - Country:US
Practice Address - Phone:512-327-2325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D&S RESIDENTIAL HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-25
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities