Celemiah Home and Community Support Service Agency

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

833814 Issued in TX

Legal business name

CELEMIAH HOME AND COMMUNITY SUPPORT SERVICE AGENCY

Practice address

17804 Bridgefarmer Blvd
Pflugerville, TX 78660-3484

Phone

(512) 825-6440

NPI assigned

Dec 17, 2015

Last updated

Dec 17, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeremiah Kipngetich Chumba, RN

Title

RN/Administrator

Phone

(512) 825-6440

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1487019436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17804 BRIDGEFARMER BLVD",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786603484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17804 BRIDGEFARMER BLVD",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786603484",
            "telephone_number": "512-825-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELEMIAH HOME AND COMMUNITY SUPPORT SERVICE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "CHUMBA",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_middle_name": "KIPNGETICH",
        "authorized_official_title_or_position": "RN/ADMINISTRATOR",
        "authorized_official_telephone_number": "512-825-6440",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "833814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Pflugerville, TX
• Providers in Pflugerville, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.