Provider Demographics
NPI:1053715276
Name:CHINEL HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:CHINEL HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOAHEMAA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:475-202-7414
Mailing Address - Street 1:39 CANTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-1712
Mailing Address - Country:US
Mailing Address - Phone:475-202-7414
Mailing Address - Fax:
Practice Address - Street 1:39 CANTON ST
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-1712
Practice Address - Country:US
Practice Address - Phone:475-202-7414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0000890251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health