Provider Demographics
NPI:1821040825
Name:COMMUNITY HOME HEALTH CARE SERVICES,LLC
Entity Type:Organization
Organization Name:COMMUNITY HOME HEALTH CARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS, ARNP
Authorized Official - Phone:941-708-5142
Mailing Address - Street 1:707 60TH STREET CT E
Mailing Address - Street 2:SUITE C
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-6279
Mailing Address - Country:US
Mailing Address - Phone:941-708-5142
Mailing Address - Fax:941-744-2624
Practice Address - Street 1:707 60TH STREET CT E
Practice Address - Street 2:SUITE C
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-6279
Practice Address - Country:US
Practice Address - Phone:941-708-5142
Practice Address - Fax:941-744-2624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107703Medicare ID - Type UnspecifiedHME HEALTH CARE PROVIDER