Provider Demographics
NPI:1457539819
Name:COMMUNITY HEALTH & EMERGENCY SERVICES, INC., DASA
Entity Type:Organization
Organization Name:COMMUNITY HEALTH & EMERGENCY SERVICES, INC., DASA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-734-4400
Mailing Address - Street 1:13245 KESSLER RD
Mailing Address - Street 2:PO BOX 233
Mailing Address - City:CAIRO
Mailing Address - State:IL
Mailing Address - Zip Code:62914-3101
Mailing Address - Country:US
Mailing Address - Phone:618-734-4400
Mailing Address - Fax:618-734-2884
Practice Address - Street 1:13245 KESSLER RD
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:IL
Practice Address - Zip Code:62914-3101
Practice Address - Country:US
Practice Address - Phone:618-734-4400
Practice Address - Fax:618-734-2884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========005Medicaid