Healthcare Provider Details

I. General information

NPI: 1841316288
Provider Name (Legal Business Name): COMMUNITY HEALTH DEVELOPMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S FRIO
CAMP WOOD TX
78833-0455
US

IV. Provider business mailing address

908 S EVANS ST
UVALDE TX
78801-6034
US

V. Phone/Fax

Practice location:
  • Phone: 830-597-6424
  • Fax: 830-597-6427
Mailing address:
  • Phone: 830-278-5604
  • Fax: 830-278-1836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License NumberZ00FM205
License Number StateTX

VIII. Authorized Official

Name: MRS. MAYELA CASTANON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 830-278-5604