Healthcare Provider Details

I. General information

NPI: 1356142921
Provider Name (Legal Business Name): COMMUNITY HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S STAGE COACH LN
FALLBROOK CA
92028-4429
US

IV. Provider business mailing address

7880 MISSION GROVE PKWY S
RIVERSIDE CA
92508-6000
US

V. Phone/Fax

Practice location:
  • Phone: 760-451-4770
  • Fax:
Mailing address:
  • Phone: 951-571-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: LORI HOLEMAN
Title or Position: CEO
Credential:
Phone: 951-571-2300