Provider Demographics
NPI:1588006803
Name:CHETRUM CORPORATION
Entity Type:Organization
Organization Name:CHETRUM CORPORATION
Other - Org Name:KEEPWELL CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLAYINKA
Authorized Official - Middle Name:VALERIE
Authorized Official - Last Name:AKINFESOYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:832-352-9335
Mailing Address - Street 1:4414 CENTERVIEW
Mailing Address - Street 2:STE 275
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1418
Mailing Address - Country:US
Mailing Address - Phone:210-255-1083
Mailing Address - Fax:210-255-1335
Practice Address - Street 1:4414 CENTERVIEW
Practice Address - Street 2:STE 275
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1418
Practice Address - Country:US
Practice Address - Phone:210-255-1083
Practice Address - Fax:210-255-1335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX015635251B00000X, 251E00000X, 251F00000X, 251G00000X, 251J00000X, 251S00000X, 251T00000X, 253Z00000X
310400000X, 3104A0630X, 311500000X, 343900000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle