Provider Demographics
NPI:1437585171
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 1:412 HIGHWAY 37 S
Mailing Address - Street 2:
Mailing Address - City:MT VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:75457-6570
Mailing Address - Country:US
Mailing Address - Phone:903-537-3600
Mailing Address - Fax:
Practice Address - Street 1:412 HIGHWAY 37 S
Practice Address - Street 2:
Practice Address - City:MT VERNON
Practice Address - State:TX
Practice Address - Zip Code:75457-6570
Practice Address - Country:US
Practice Address - Phone:903-537-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1021298251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health