Healthcare Provider Details
I. General information
NPI: 1932472289
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/17/2012
Last Update Date: 02/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
849 GREENWAY PROFESSIONAL CT
ORLANDO FL
32824-9482
US
IV. Provider business mailing address
110 S WOODLAND ST
WINTER GARDEN FL
34787-3546
US
V. Phone/Fax
- Phone: 407-905-8827
- Fax: 321-221-1057
- Phone: 407-905-8827
- Fax: 321-221-1057
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARGARET
BRENNAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 407-905-8827