Provider Demographics
NPI:1790187813
Name:COMMUNITY SERVICES OF NORTHEAST TEXAS, INC.
Entity Type:Organization
Organization Name:COMMUNITY SERVICES OF NORTHEAST TEXAS, INC.
Other - Org Name:CSNT
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:LUCKY
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:NCRT
Authorized Official - Phone:903-756-5596
Mailing Address - Street 1:304 E HOUSTON ST
Mailing Address - Street 2:BOX 427
Mailing Address - City:LINDEN
Mailing Address - State:TX
Mailing Address - Zip Code:75563
Mailing Address - Country:US
Mailing Address - Phone:903-756-5596
Mailing Address - Fax:903-756-7294
Practice Address - Street 1:304 E HOUSTON ST
Practice Address - Street 2:BOX 427
Practice Address - City:LINDEN
Practice Address - State:TX
Practice Address - Zip Code:75563
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:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable