MEDICARE: CHILTON AND LESTE MANAGEMENT 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	251G00000X	Community Based Hospice Care Agency	070000575	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518949874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILTON AND LESTE MANAGEMENT INC.

Provider Business Mailing Address
First Line	:	5401 TECH CIR
Second Line	:
City	:	MOORPARK
State	:	CA
Zip	:	93021-1769
Country	:	US
Telephone Number	:	805-517-1620
Fax Number	:	805-517-1623

Provider Business Practice Location Address
First Line	:	5401 TECH CIR
Second Line	:
City	:	MOORPARK
State	:	CA
Zip	:	93021-1769
Country	:	US
Telephone Number	:	805-517-1620
Fax Number	:	805-517-1623

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SHELLEY CHILTON
Credential	:
Telephone Number	:	805-517-1620

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	03/08/2023

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