Provider Demographics
NPI:1851997712
Name:WP-ARC CHATHAM HOLDINGS, LLC
Entity Type:Organization
Organization Name:WP-ARC CHATHAM HOLDINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT ANALYST
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-595-6025
Mailing Address - Street 1:825 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62629-1737
Mailing Address - Country:US
Mailing Address - Phone:217-483-4661
Mailing Address - Fax:217-483-4662
Practice Address - Street 1:825 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:IL
Practice Address - Zip Code:62629-1737
Practice Address - Country:US
Practice Address - Phone:217-483-4661
Practice Address - Fax:217-483-4662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility