Healthcare Provider Details

I. General information

NPI: 1821063249
Provider Name (Legal Business Name): COMMUNITY HEALTHCARE SYSTEM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 06/02/2020
Certification Date: 06/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 1ST ST
CENTRALIA KS
66415-9637
US

IV. Provider business mailing address

604 1ST ST
CENTRALIA KS
66415-9637
US

V. Phone/Fax

Practice location:
  • Phone: 785-857-3388
  • Fax: 785-857-3349
Mailing address:
  • Phone: 785-857-3388
  • Fax: 785-857-3349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberN066006
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN066006
License Number StateKS

VIII. Authorized Official

Name: MR. TODD M WILLERT
Title or Position: CEO
Credential:
Phone: 785-889-5002