Provider Demographics
NPI:1447890918
Name:COMMUNITY HOME CARE SERVICES INC
Entity type:Organization
Organization Name:COMMUNITY HOME CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEESTMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-228-8289
Mailing Address - Street 1:1909A S HEATON ST
Mailing Address - Street 2:
Mailing Address - City:KNOX
Mailing Address - State:IN
Mailing Address - Zip Code:46534-2325
Mailing Address - Country:US
Mailing Address - Phone:574-772-3157
Mailing Address - Fax:574-772-3175
Practice Address - Street 1:1909A S HEATON ST
Practice Address - Street 2:
Practice Address - City:KNOX
Practice Address - State:IN
Practice Address - Zip Code:46534-2325
Practice Address - Country:US
Practice Address - Phone:574-772-3157
Practice Address - Fax:574-772-3175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health