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General NPI Number Information
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NPI Number | 1619168242
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 08/08/2007
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Provider Practice Location Address
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Address Line | 236 CHESTNUT ST
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City | CLERMONT
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State | FL
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Zip | 34711-3020
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Country | US
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Telephone | 352-394-0038
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Fax | 352-394-0038
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Provider Business Mailing Address
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Address Line | PO BOX 120934
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City | CLERMONT
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State | FL
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Zip | 34712-0934
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Country | US
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Telephone | 352-394-0038
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Fax | 352-394-0038
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Authorized Official
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Title or Position | TREASURER
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Name | MS. ELIZABETH A BEEBE
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Credential |
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Telephone | 352-394-2644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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