Provider Demographics
NPI:1669633095
Name:ND COMMUNITY SUPPORTS, INC.
Entity Type:Organization
Organization Name:ND COMMUNITY SUPPORTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN-CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LATONIA
Authorized Official - Middle Name:TAMARA
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-743-9730
Mailing Address - Street 1:9026 WELLESLEY DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5016
Mailing Address - Country:US
Mailing Address - Phone:512-743-9730
Mailing Address - Fax:
Practice Address - Street 1:9026 WELLESLEY DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5016
Practice Address - Country:US
Practice Address - Phone:512-743-9730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility