Basic Information
| Provider Information | |||||||||
| NPI: | 1679510093 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COMMUNITY CARE SERVICES INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| OtherOrganizationName: | CCS HOSPICE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 118 E LIVE OAK ST | ||||||||
| Address2: | |||||||||
| City: | DUBLIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 764461941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2544452517 | ||||||||
| FaxNumber: | 2544453960 | ||||||||
| Practice Location | |||||||||
| Address1: | 118 E LIVE OAK ST | ||||||||
| Address2: | |||||||||
| City: | DUBLIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 764461941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2544454675 | ||||||||
| FaxNumber: | 2544452972 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | NICHOLS | ||||||||
| AuthorizedOfficialFirstName: | BOBBIE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | V. PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2544452517 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | 002671 | TX | Y | Agencies | Hospice Care, Community Based |
No ID Information.