=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326236464
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ELLIS COUNTY COALITION FOR HEALTH OPTIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2007
-----------------------------------------------------
Last Update Date | 06/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 572 COLEMAN ST
-----------------------------------------------------
City | WAXAHACHIE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75165-2837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-923-2440
-----------------------------------------------------
Fax | 972-923-2445
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 572 COLEMAN ST
-----------------------------------------------------
City | WAXAHACHIE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75165-2837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-923-2440
-----------------------------------------------------
Fax | 972-923-2445
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
Name | MRS. KATHLEEN MARSHALL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 972-923-2440
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QF0400X
-----------------------------------------------------
Taxonomy Name | Federally Qualified Health Center (FQHC)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------