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

General Provider Information

NPI Number	:	1710938972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARTWELL COMMUNITY SERVICES, INC.

Provider Business Mailing Address
First Line	:	4444 CORONA DR
Second Line	:	SUITE 233
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-4324
Country	:	US
Telephone Number	:	631-855-2090
Fax Number	:	361-855-0973

Provider Business Practice Location Address
First Line	:	4444 CORONA DR
Second Line	:	SUITE 233
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-4324
Country	:	US
Telephone Number	:	631-855-2090
Fax Number	:	361-855-0973

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	:	01/07/2019

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