Provider Demographics
NPI:1215109178
Name:DSA, INC.
Entity type:Organization
Organization Name:DSA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:C
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-576-9794
Mailing Address - Street 1:16 BELLERIVE CNTRY CLUB GROUNDS
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7320
Mailing Address - Country:US
Mailing Address - Phone:314-576-9794
Mailing Address - Fax:314-205-8710
Practice Address - Street 1:16 BELLERIVE CNTRY CLUB GROUNDS
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7320
Practice Address - Country:US
Practice Address - Phone:314-576-9794
Practice Address - Fax:314-205-8710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services