Provider Demographics
NPI:1578088738
Name:CDS LLC
Entity Type:Organization
Organization Name:CDS LLC
Other - Org Name:SILVER PINES TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:DUMONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-234-7886
Mailing Address - Street 1:5 WHITE OWL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MAHANOY CITY
Mailing Address - State:PA
Mailing Address - Zip Code:17948-3000
Mailing Address - Country:US
Mailing Address - Phone:570-773-5388
Mailing Address - Fax:570-773-5391
Practice Address - Street 1:5 WHITE OWL DRIVE
Practice Address - Street 2:
Practice Address - City:MAHANOY CITY
Practice Address - State:PA
Practice Address - Zip Code:17948-3000
Practice Address - Country:US
Practice Address - Phone:570-773-5388
Practice Address - Fax:570-773-5391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-09
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
323P00000X
PA547032324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility