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? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |