Provider Demographics
NPI:1578775441
Name:CHARTWELL COMMUNITY SERVICES INC.
Entity Type:Organization
Organization Name:CHARTWELL COMMUNITY SERVICES INC.
Other - Org Name:ELARA CARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONASTIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-768-4373
Mailing Address - Street 1:3010 LYNDON B JOHNSON FWY STE 1100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2712
Mailing Address - Country:US
Mailing Address - Phone:517-768-4373
Mailing Address - Fax:903-537-8420
Practice Address - Street 1:749 GATEWAY STREET
Practice Address - Street 2:SUITE 502, BLDG E
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-0004
Practice Address - Country:US
Practice Address - Phone:325-692-4403
Practice Address - Fax:325-793-7340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011268251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001001541Medicaid
TX945642165OtherANSI
TX945533160OtherTDH CONNECT