Provider Demographics
NPI:1598897944
Name:COMMUNITY SERVICES OF NORTHEAST TEXAS, INC
Entity Type:Organization
Organization Name:COMMUNITY SERVICES OF NORTHEAST TEXAS, INC
Other - Org Name:COMMUNITY COUNCIL OF CASS, MARION AND MORRIS COUNTIES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-756-5596
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:TX
Mailing Address - Zip Code:75563-0427
Mailing Address - Country:US
Mailing Address - Phone:903-756-5596
Mailing Address - Fax:903-756-7294
Practice Address - Street 1:304 E HOUSTON
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:TX
Practice Address - Zip Code:75563-0427
Practice Address - Country:US
Practice Address - Phone:903-756-5596
Practice Address - Fax:903-756-7294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty