Provider Demographics
NPI:1518904390
Name:COMMUNITY HEALTH & EMERGENCY SERVICES, INC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH & EMERGENCY SERVICES, INC
Other - Org Name:DAYSTAR CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:618-734-1700
Mailing Address - Street 1:2001 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:IL
Mailing Address - Zip Code:62914-1710
Mailing Address - Country:US
Mailing Address - Phone:618-734-1700
Mailing Address - Fax:618-734-2611
Practice Address - Street 1:2001 CEDAR ST
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:IL
Practice Address - Zip Code:62914-1710
Practice Address - Country:US
Practice Address - Phone:618-734-1700
Practice Address - Fax:618-734-2611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1684744314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL371088946001Medicaid
IL=========017Medicaid
IL146002Medicare Oscar/Certification