Provider Demographics
NPI:1154534394
Name:CHASE - EDWARD INC.
Entity type:Organization
Organization Name:CHASE - EDWARD INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:LINNEA
Authorized Official - Last Name:FRERIKS
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:616-395-2653
Mailing Address - Street 1:837 MAPLE AVE
Mailing Address - Street 2:SUITE 20
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-7145
Mailing Address - Country:US
Mailing Address - Phone:616-395-2653
Mailing Address - Fax:616-796-0274
Practice Address - Street 1:837 MAPLE AVE
Practice Address - Street 2:SUITE 20
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-7145
Practice Address - Country:US
Practice Address - Phone:616-395-2653
Practice Address - Fax:616-796-0274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherNON-MEDICAL HOME CARE