MEDICARE: D&S RESIDENTIAL SERVICES, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315P00000X	Intellectual Disabilities Intermediate Care Facility

General Provider Information

NPI Number	:	1326577842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D&S RESIDENTIAL SERVICES, LP

Provider Business Mailing Address
First Line	:	8911 N. CAPITAL OF TEXAS HWY., BLDG. 1
Second Line	:	STE. 1300
City	:	AUSTIN
State	:	TX
Zip	:	78759
Country	:	US
Telephone Number	:	512-327-2325
Fax Number	:

Provider Business Practice Location Address
First Line	:	1405 JEFFERSON ST
Second Line	:
City	:	BASTROP
State	:	TX
Zip	:	78602-3016
Country	:	US
Telephone Number	:	512-303-7638
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	BRETT IAN COHEN
Credential	:
Telephone Number	:	800-388-5150

Provider Enumeration Date	:	06/08/2017
Last Update Date	:	03/04/2023

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