Provider Demographics
NPI:1952527475
Name:CSA ENTERPRISE, INC.
Entity type:Organization
Organization Name:CSA ENTERPRISE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DWANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:214-552-8128
Mailing Address - Street 1:15707 COIT RD STE C
Mailing Address - Street 2:119
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4463
Mailing Address - Country:US
Mailing Address - Phone:214-552-8128
Mailing Address - Fax:972-542-8799
Practice Address - Street 1:3309 SEDONA LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4455
Practice Address - Country:US
Practice Address - Phone:214-552-8128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child