Provider Demographics
NPI:1619168242
Name:COMMUNITY CARE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:COMMUNITY CARE HEALTH SERVICES, INC.
Other - Org Name:SOUTH LAKE ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEEBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-394-2644
Mailing Address - Street 1:PO BOX 120934
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34712-0934
Mailing Address - Country:US
Mailing Address - Phone:352-394-0038
Mailing Address - Fax:352-394-0038
Practice Address - Street 1:236 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-3020
Practice Address - Country:US
Practice Address - Phone:352-394-0038
Practice Address - Fax:352-394-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care