Healthcare Provider Details

I. General information

NPI: 1679510093
Provider Name (Legal Business Name): COMMUNITY CARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 E LIVE OAK ST
DUBLIN TX
76446-1941
US

IV. Provider business mailing address

118 E LIVE OAK ST
DUBLIN TX
76446-1941
US

V. Phone/Fax

Practice location:
  • Phone: 254-445-4675
  • Fax: 254-445-2972
Mailing address:
  • Phone: 254-445-2517
  • Fax: 254-445-3960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number002671
License Number StateTX

VIII. Authorized Official

Name: BOBBIE M NICHOLS
Title or Position: V. PRESIDENT
Credential:
Phone: 254-445-2517