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NPI Code Detail

MEDICARE: ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES

MEDICARE: ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES
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
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11007139OTHERTXCONTRACT NUMBER

General Provider Information

NPI Number : 1558563197
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES
Provider Business Mailing Address
First Line : 5656 NORTH JACKSON
Second Line :
City : JACKSONVILLE
State : TX
Zip : 75766-9641
Country : US
Telephone Number : 903-589-9000
Fax Number : 903-589-3443
Provider Business Practice Location Address
First Line : 5656 NORTH JACKSON
Second Line :
City : JACKSONVILLE
State : TX
Zip : 75766-9641
Country : US
Telephone Number : 903-589-9000
Fax Number : 903-589-3443
Authorized Official
Title or Position : REIMBURSEMENT COORDINATOR
Name : MRS. DIANNA L STROM
Credential :
Telephone Number : 903-589-9000
Provider Enumeration Date : 06/05/2007
Last Update Date : 03/31/2008

Similar Medicare Providers

1124022918 — JILL K PONTIUS MD
Practice Location Address:
5656 N JACKSON ST
JACKSONVILLE, TX
75766-9641
Practice Phone: 903-589-9000
Practice Fax: 903-586-9200
1497759237 — ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES
Practice Location Address:
5656 N JACKSON ST
JACKSONVILLE, TX
75766-9641
Practice Phone: 903-589-9000
Practice Fax: 903-586-9200
1154325645 — ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES
Practice Location Address:
5656 N JACKSON ST
JACKSONVILLE, TX
75766-9641
Practice Phone: 903-589-9000
Practice Fax: 903-586-9200
1770527350 — LESLIE Z GLOVER LPC
Practice Location Address:
5656 N JACKSON ST
JACKSONVILLE, TX
75766-9641
Practice Phone: 903-589-9000
Practice Fax: 903-586-9200
1457553091 — ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES
Practice Location Address:
5656 NORTH JACKSON
JACKSONVILLE, TX
75766-9641
Practice Phone: 903-589-9000
Practice Fax: 903-589-3443
1639327877 — DENNIS RAY PHILLIPS LCSW
Practice Location Address:
5656 N JACKSON ST
JACKSONVILLE, TX
75766-9641
Practice Phone: 903-589-9000
Practice Fax: 903-589-3443

Directions to “ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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