Healthcare Provider Details

I. General information

NPI: 1164791430
Provider Name (Legal Business Name): CHAPTERS HEALTH HOME CONNECT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2011
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12470 TELECOM DR STE 300W
TEMPLE TERRACE FL
33637-0904
US

IV. Provider business mailing address

12470 TELECOM DR STE 300W ATTN LEGAL DEPT.
TEMPLE TERRACE FL
33637-0904
US

V. Phone/Fax

Practice location:
  • Phone: 813-871-8111
  • Fax:
Mailing address:
  • Phone: 813-871-8400
  • Fax: 813-871-8402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: DARRELL WHITE
Title or Position: CHIEF LEGAL OFFICER
Credential:
Phone: 813-871-8400