MEDICARE: CHAMBERS ENTERPRISES SERVICING 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	261QD1600X	Developmental Disabilities Clinic/Center

General Provider Information

NPI Number	:	1326532029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMBERS ENTERPRISES SERVICING INC

Provider Business Mailing Address
First Line	:	839 NW GREENWICH CT
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34983-3403
Country	:	US
Telephone Number	:	772-672-1558
Fax Number	:

Provider Business Practice Location Address
First Line	:	839 NW GREENWICH CT
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34983-3403
Country	:	US
Telephone Number	:	772-672-1558
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DAMONTE CHAMBERS
Credential	:
Telephone Number	:	772-672-1558

Provider Enumeration Date	:	06/18/2018
Last Update Date	:	06/18/2018

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