Provider Demographics
NPI:1316441579
Name:COMMUNITY HOME CARE SERVICES
Entity type:Organization
Organization Name:COMMUNITY HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-702-8339
Mailing Address - Street 1:N112W16298 MEQUON RD # 127
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-3306
Mailing Address - Country:US
Mailing Address - Phone:414-702-8339
Mailing Address - Fax:414-435-3152
Practice Address - Street 1:N112 W16298 MEQUON RD
Practice Address - Street 2:127
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022
Practice Address - Country:US
Practice Address - Phone:414-702-8339
Practice Address - Fax:414-435-3152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI100074193251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health