Provider Demographics
NPI:1821204587
Name:D&S RESIDENTIAL SERVICES, LP
Entity Type:Organization
Organization Name:D&S RESIDENTIAL SERVICES, LP
Other - Org Name:CASA DE CONCHO
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 NORTH CAPITAL OF TEXAS HIGHWAY
Mailing Address - Street 2:BUILDING 1, SUITE 1300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-7203
Mailing Address - Country:US
Mailing Address - Phone:512-327-2325
Mailing Address - Fax:512-263-2161
Practice Address - Street 1:2706 WATSON STREET
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76905
Practice Address - Country:US
Practice Address - Phone:325-658-1957
Practice Address - Fax:325-223-0513
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D&S RESIDENTIAL HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-16
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001014262315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001014262Medicaid