Healthcare Provider Details

I. General information

NPI: 1144693813
Provider Name (Legal Business Name): CHAPPELL HILL PERSONAL ASSISTANT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2015
Last Update Date: 11/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 S AUSTIN ST
BRENHAM TX
77833-4117
US

IV. Provider business mailing address

904 S AUSTIN ST
BRENHAM TX
77833-4117
US

V. Phone/Fax

Practice location:
  • Phone: 832-298-4563
  • Fax:
Mailing address:
  • Phone: 832-298-4563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RICHARD A EKIBOLAJI
Title or Position: ADMINISTRATOR
Credential:
Phone: 832-298-4563