MEDICARE: CHAPPELL HILL PERSONAL ASSISTANCE SERVICES LLC

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	:	1366801268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAPPELL HILL PERSONAL ASSISTANCE SERVICES LLC

Provider Business Mailing Address
First Line	:	904 S AUSTIN ST
Second Line	:
City	:	BRENHAM
State	:	TX
Zip	:	77833-4117
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	904 S AUSTIN ST
Second Line	:
City	:	BRENHAM
State	:	TX
Zip	:	77833-4117
Country	:	US
Telephone Number	:	281-217-5277
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. VICTOR ABOLO
Credential	:
Telephone Number	:	281-217-5277

Provider Enumeration Date	:	02/19/2016
Last Update Date	:	02/19/2016

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