Provider Demographics
NPI:1881838522
Name:COMMUNITY HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:COMMUNITY HOME HEALTH SERVICES LLC
Other - Org Name:COMMUNITY HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKSIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:307-864-5585
Mailing Address - Street 1:837 BIG HORN ST
Mailing Address - Street 2:
Mailing Address - City:THERMOPOLIS
Mailing Address - State:WY
Mailing Address - Zip Code:82443-2347
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:224 S 6TH ST
Practice Address - Street 2:
Practice Address - City:THERMOPOLIS
Practice Address - State:WY
Practice Address - Zip Code:82443-2608
Practice Address - Country:US
Practice Address - Phone:307-864-5585
Practice Address - Fax:307-864-5471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-24
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY537052Medicare PIN