Provider Demographics
NPI:1740042274
Name:CHS EMPLOYEE GROUP, LLC
Entity type:Organization
Organization Name:CHS EMPLOYEE GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:MISS
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIMONGELLI
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:215-239-7182
Mailing Address - Street 1:43201 DELAIRE LANDING RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-5311
Mailing Address - Country:US
Mailing Address - Phone:215-239-7182
Mailing Address - Fax:
Practice Address - Street 1:43201 DELAIRE LANDING RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-5311
Practice Address - Country:US
Practice Address - Phone:215-239-7182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty