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General NPI Number Information
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NPI Number | 1700821097
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Entity Type | Organization
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Legal Business Name | CENTERWELL HEALTH SERVICES CERTIFIED, INC.
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 5265 OFFICE PARK BLVD STE 101
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City | BRADENTON
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State | FL
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Zip | 34203-3441
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Country | US
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Telephone | 941-749-2990
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Fax |
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Provider Business Mailing Address
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Address Line | 6330 SPRINT PKWY STE 300
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City | OVERLAND PARK
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State | KS
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Zip | 66211-1157
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED SIGNATORY
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Name | JOHN NICHOLS
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Credential |
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Telephone | 941-749-2990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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