Healthcare Provider Details
I. General information
NPI: 1942406137
Provider Name (Legal Business Name): COMMUNITY HEALTH CLINICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2007
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2301 N 36TH ST STE 102
BOISE ID
83703-5202
US
IV. Provider business mailing address
PO BOX 9
NAMPA ID
83653-0009
US
V. Phone/Fax
- Phone: 208-336-8801
- Fax: 208-466-5359
- Phone: 208-467-4431
- Fax: 208-467-7684
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINA
JO
ZIMMERMAN
Title or Position: BILLING MANAGER
Credential:
Phone: 208-461-7149