Healthcare Provider Details
I. General information
NPI: 1003752353
Provider Name (Legal Business Name): COMMUNITY HEALTH CLINICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2216 W FAIRVIEW AVE
BOISE ID
83702-6844
US
IV. Provider business mailing address
PO BOX 9
NAMPA ID
83653-0009
US
V. Phone/Fax
- Phone: 208-721-5070
- Fax: 208-466-5359
- Phone: 208-467-4431
- Fax: 208-466-5359
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HEIDI
HART
Title or Position: CEO
Credential:
Phone: 208-318-1255