Provider Demographics
NPI:1285465658
Name:CENTERWELL HEALTH SERVICES (USA), LLC
Entity type:Organization
Organization Name:CENTERWELL HEALTH SERVICES (USA), LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED SIGNATORY
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-722-0515
Mailing Address - Street 1:1480 CORNERSTONE CT
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-3896
Mailing Address - Country:US
Mailing Address - Phone:409-722-0515
Mailing Address - Fax:
Practice Address - Street 1:1480 CORNERSTONE CT
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-3896
Practice Address - Country:US
Practice Address - Phone:409-722-0515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health