Healthcare Provider Details

I. General information

NPI: 1649592452
Provider Name (Legal Business Name): COMMUNICATION SERVICES FOR THE DEAF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2010
Last Update Date: 02/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 STANLEY AVE
DAYTON OH
45404-2022
US

IV. Provider business mailing address

102 N KROHN PL
SIOUX FALLS SD
57103-1800
US

V. Phone/Fax

Practice location:
  • Phone: 937-227-3272
  • Fax: 605-367-5958
Mailing address:
  • Phone: 605-367-5760
  • Fax: 605-367-5958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. BENJAMIN J SOUKUP
Title or Position: CEO
Credential:
Phone: 605-367-5670