OrganizationActive
Cg-Dsa, LLC
NPI 1205401452 · Intellectual Disabilities Intermediate Care Facility · Lebanon, IN
Provider details
- NPI number
- 1205401452
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Parent organization
- Cg-Dsa, LLC
- Organization subpart
- Yes
- Authorized official
- Anna Todd, Operations Business Manager(800) 299-5161
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
1275 Middle Jamestown Rd
Lebanon, IN 46052-9404
Phone: (765) 361-1950
Approximate (ZIP-level) locationGet directions
Mailing address
4800 Overton Plz Ste 440
Fort Worth, TX 76109-4435
Registry dates
- Enumerated
- 2021-05-20
- Last updated
- 2021-05-20
- Certified
- 2021-05-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.