Provider Demographics
NPI:1043990880
Name:CHALEAH& CHARLOTTE HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:CHALEAH& CHARLOTTE HOME HEALTH SERVICES
Other - Org Name:DEAR ME A.W.A.K.E
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHALEAH
Authorized Official - Middle Name:MARTIA
Authorized Official - Last Name:MYRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-578-3362
Mailing Address - Street 1:2946 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32254-1925
Mailing Address - Country:US
Mailing Address - Phone:904-578-3362
Mailing Address - Fax:
Practice Address - Street 1:2946 W 11TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32254-1925
Practice Address - Country:US
Practice Address - Phone:904-578-3362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty