Basic Information
| Provider Information | |||||||||
| NPI: | 1417210485 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY HEALTH CARE SOLUTIONS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2800 YOUREE DR STE 482 | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711043666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3188691899 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2800 YOUREE DR STE 482 | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711043666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3188691899 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2012 | ||||||||
| LastUpdateDate: | 06/24/2012 | ||||||||
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| AuthorizedOfficialLastName: | BURNOM | ||||||||
| AuthorizedOfficialFirstName: | YOLANDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3187340663 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 8068 | LA | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 251E00000X | 8068 | LA | N | Agencies | Home Health | 251S00000X | 8068 | LA | N | Agencies | Community/Behavioral Health | 253Z00000X | 8068 | LA | N | Agencies | In Home Supportive Care | 251B00000X | 8068 | LA | Y | Agencies | Case Management |
No ID Information.