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General NPI Number Information
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NPI Number | 1104259449
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Entity Type | Organization
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Legal Business Name | CSI PRIVATE DUTY SERVICES, INC
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Dates
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Enumeration Date | 08/09/2013
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 2646 SW MAPP RD STE 305
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City | PALM CITY
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State | FL
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Zip | 34990-2758
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Country | US
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Telephone | 772-221-9363
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Fax | 866-961-3463
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Provider Business Mailing Address
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Address Line | 33 S STATE ST FL 5
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City | CHICAGO
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State | IL
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Zip | 60603-2804
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Country | US
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Telephone | 312-762-9999
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Fax |
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Authorized Official
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Title or Position | CHIEF LEGAL OFFICER, SECRETARY
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Name | JOSEPH BONACCORSI
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Credential |
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Telephone | 312-762-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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