Provider Demographics
NPI:1235475351
Name:CHI NATIONAL HOME CARE, LLC
Entity Type:Organization
Organization Name:CHI NATIONAL HOME CARE, LLC
Other - Org Name:CHI HEALTH AT HOME - LINCOLN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V.P. FINANCE & CFO
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-576-8478
Mailing Address - Street 1:6281 TRI RIDGE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-8345
Mailing Address - Country:US
Mailing Address - Phone:513-576-0262
Mailing Address - Fax:
Practice Address - Street 1:245 S 84TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2680
Practice Address - Country:US
Practice Address - Phone:402-219-7043
Practice Address - Fax:402-219-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
28-1507OtherMEDICARE
NE10026366100Medicaid