Provider Demographics
NPI:1255978854
Name:CITADEL COMMUNITY HEALTH SERVICES
Entity type:Organization
Organization Name:CITADEL COMMUNITY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ONYINYE
Authorized Official - Middle Name:ABIGAIL
Authorized Official - Last Name:OKEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-343-3115
Mailing Address - Street 1:1000 PARKWOOD CIR SE STE 900
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2140
Mailing Address - Country:US
Mailing Address - Phone:305-343-3115
Mailing Address - Fax:
Practice Address - Street 1:1000 PARKWOOD CIR SE STE 900
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2140
Practice Address - Country:US
Practice Address - Phone:305-343-3115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care