MEDICARE: CHARTWELL COMMUNITY SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001001534	OTHER	TX	PHC CONTRACT
2	011267	OTHER	TX	STATE LICENSE

General Provider Information

NPI Number	:	1356392518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARTWELL COMMUNITY SERVICES, INC.

Provider Business Mailing Address
First Line	:	3010 LYNDON B JOHNSON FWY STE 1100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-2712
Country	:	US
Telephone Number	:	800-234-1866
Fax Number	:	903-537-8420

Provider Business Practice Location Address
First Line	:	4205 FAIRMONT PKWY STE 150
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-3324
Country	:	US
Telephone Number	:	713-472-3198
Fax Number	:	713-472-2587

Authorized Official
Title or Position	:	VICE PRESIDENT OF REGULATORY
Name	:	DEBRA MILLER
Credential	:
Telephone Number	:	800-234-1866

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	05/11/2021

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Directions to “CHARTWELL COMMUNITY SERVICES, INC. ” Practice Location

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