Provider Demographics
NPI:1447327911
Name:COMMUNITY HEALTH PROFESSIONALS, INC.
Entity type:Organization
Organization Name:COMMUNITY HEALTH PROFESSIONALS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:TOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-238-9223
Mailing Address - Street 1:4392 SR 235
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OH
Mailing Address - Zip Code:45810-9503
Mailing Address - Country:US
Mailing Address - Phone:419-634-7443
Mailing Address - Fax:419-634-7447
Practice Address - Street 1:4392 SR 235
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OH
Practice Address - Zip Code:45810-9503
Practice Address - Country:US
Practice Address - Phone:419-634-7443
Practice Address - Fax:419-634-7447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2080448Medicaid
OH367331Medicare Oscar/Certification