Provider Demographics
NPI:1104956846
Name:COMMUNITY DEVELOPMENTAL SERVICES, INC
Entity type:Organization
Organization Name:COMMUNITY DEVELOPMENTAL SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-587-3851
Mailing Address - Street 1:455 HANNINGS LANE
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237
Mailing Address - Country:US
Mailing Address - Phone:731-587-3851
Mailing Address - Fax:731-587-0548
Practice Address - Street 1:455 HANNINGS LANE
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237
Practice Address - Country:US
Practice Address - Phone:731-587-3851
Practice Address - Fax:731-587-0548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services