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Organization

CENTERWELL CERTIFIED HEALTHCARE CORP.

Active
Other names
CenterWell Home Health
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN NICHOLS (AUTHORIZED SIGNATORY)
(805) 544-4402
Entity
Organization

Contact information

Practice address
805 AEROVISTA PL STE 204, SAN LUIS OBISPO, CA 93401-7920
(440) 280-5544
Mailing address
6330 SPRINT PKWY STE 400, OVERLAND PARK, KS 66211-1171

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
013100P
CA-COMMERCIAL NUMBER
01
05-7203
CA-COMMERCIAL NUMBER
01
050000095
CA-COMMERCIAL NUMBER
01
057203
CA-COMMERCIAL NUMBER
01
106825020
CA-COMMERCIAL NUMBER
01
564457
CA-COMMERCIAL NUMBER
01
5868461
CA-COMMERCIAL NUMBER
01
ANC015
CA-COMMERCIAL NUMBER
01
GA0592
CA-COMMERCIAL NUMBER
05
HHA07203G
CA
01
ZZZ35475Z
CA-BLUE SHIELD
Enumeration date
06/24/2006
Last updated
10/17/2023
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