Provider Demographics
NPI:1891755476
Name:COMMUNITY DEVELOPMENTAL SERVICES, INC.
Entity Type:Organization
Organization Name:COMMUNITY DEVELOPMENTAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BS, DO
Authorized Official - Phone:407-358-9427
Mailing Address - Street 1:2023 JOHN HENRY CIR
Mailing Address - Street 2:SUITE # 425
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-3450
Mailing Address - Country:US
Mailing Address - Phone:407-766-5203
Mailing Address - Fax:407-358-9427
Practice Address - Street 1:2023 JOHN HENRY CIR
Practice Address - Street 2:SUITE # 425
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-3450
Practice Address - Country:US
Practice Address - Phone:407-766-5203
Practice Address - Fax:407-358-9427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF001251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based