Provider Demographics
NPI:1396901393
Name:CHS PERSONAL CARE, LLC
Entity type:Organization
Organization Name:CHS PERSONAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-725-8496
Mailing Address - Street 1:608 N. DIBBLE ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:TUSKEGEE
Mailing Address - State:AL
Mailing Address - Zip Code:36083-1509
Mailing Address - Country:US
Mailing Address - Phone:334-725-8496
Mailing Address - Fax:334-727-9995
Practice Address - Street 1:608 N. DIBBLE ST
Practice Address - Street 2:SUITE 8
Practice Address - City:TUSKEGEE
Practice Address - State:AL
Practice Address - Zip Code:36083-1509
Practice Address - Country:US
Practice Address - Phone:334-725-8496
Practice Address - Fax:334-727-9995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL253Z00000XOtherBCBS OF ALABAMA