Provider Demographics
NPI:1376236000
Name:CK SENIOR CARE LLC
Entity Type:Organization
Organization Name:CK SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANDLER
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-399-2294
Mailing Address - Street 1:22519 S 225TH WAY
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-5678
Mailing Address - Country:US
Mailing Address - Phone:480-399-2294
Mailing Address - Fax:
Practice Address - Street 1:22519 S 225TH WAY
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-5678
Practice Address - Country:US
Practice Address - Phone:480-399-2294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care