Provider Demographics
NPI:1679866388
Name:COMMUNITY IN HOME CARE, LLC
Entity Type:Organization
Organization Name:COMMUNITY IN HOME CARE, LLC
Other - Org Name:CHAVERA HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:GOULBOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-695-3016
Mailing Address - Street 1:126 SW OAK ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65610-8981
Mailing Address - Country:US
Mailing Address - Phone:417-695-3016
Mailing Address - Fax:
Practice Address - Street 1:126 SW OAK ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MO
Practice Address - Zip Code:65610-8981
Practice Address - Country:US
Practice Address - Phone:417-695-3016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care