Provider Demographics
NPI:1174846588
Name:CERTIFIED HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:CERTIFIED HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEELEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-757-8046
Mailing Address - Street 1:3540 CLEMMONS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-9394
Mailing Address - Country:US
Mailing Address - Phone:336-757-8046
Mailing Address - Fax:888-418-3265
Practice Address - Street 1:3540 CLEMMONS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-9394
Practice Address - Country:US
Practice Address - Phone:336-757-8046
Practice Address - Fax:888-418-3265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4218251F00000X, 251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care