MEDICARE: CHELSEA HOME HEALTHCARE, 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	:	1255671590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHELSEA HOME HEALTHCARE, INC

Provider Business Mailing Address
First Line	:	1908 NEEDMORE RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45414-3808
Country	:	US
Telephone Number	:	937-278-5906
Fax Number	:	937-278-5947

Provider Business Practice Location Address
First Line	:	1908 NEEDMORE RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45414-3808
Country	:	US
Telephone Number	:	937-278-5906
Fax Number	:	937-278-5947

Authorized Official
Title or Position	:	CEO
Name	:	MR. FIDELIS NJOCK ELOKOBI
Credential	:	RN, BSN
Telephone Number	:	937-278-5906

Provider Enumeration Date	:	02/24/2013
Last Update Date	:	02/25/2013

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