Provider Demographics
NPI:1710114806
Name:CHRISTIAN HOME CARE
Entity Type:Organization
Organization Name:CHRISTIAN HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-321-0098
Mailing Address - Street 1:200 S MASSEY ST
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:NC
Mailing Address - Zip Code:27576-3008
Mailing Address - Country:US
Mailing Address - Phone:202-321-0098
Mailing Address - Fax:
Practice Address - Street 1:200 S MASSEY ST
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:NC
Practice Address - Zip Code:27576-3008
Practice Address - Country:US
Practice Address - Phone:202-321-0098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health