Provider Demographics
NPI:1174628606
Name:CHARTWELL COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:CHARTWELL COMMUNITY SERVICES, INC.
Other - Org Name:JORDAN HEALTH SERVICES, A PART OF THE ELARA CARING NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF REGULATORY
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-234-1866
Mailing Address - Street 1:1505 CALLE DEL NORTE
Mailing Address - Street 2:#375
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6036
Mailing Address - Country:US
Mailing Address - Phone:956-724-9825
Mailing Address - Fax:956-724-7431
Practice Address - Street 1:1505 CALLE DEL NORTE
Practice Address - Street 2:#375
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6036
Practice Address - Country:US
Practice Address - Phone:956-724-9825
Practice Address - Fax:956-724-7431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health