Healthcare Provider Details

I. General information

NPI: 1386047629
Provider Name (Legal Business Name): CHEROKEE COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 COLLEGE AVE
JACKSONVILLE TX
75766-2936
US

IV. Provider business mailing address

803 COLLEGE AVE
JACKSONVILLE TX
75766-2936
US

V. Phone/Fax

Practice location:
  • Phone: 903-586-6191
  • Fax: 903-586-3572
Mailing address:
  • Phone: 903-586-6191
  • Fax: 903-586-3572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: ALLISON K HALE
Title or Position: EXECUTIVE DIRECTOR
Credential: B.S C.M
Phone: 903-586-6191