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CHRIST COMMUNITY HEALTH SERVICES INC. NPI 1942788567


NPI Information

NPI: 1942788567
Provider Name: CHRIST COMMUNITY HEALTH SERVICES, INC.

Other Name: CHRIST COMMUNITY DENTAL OUTREACH

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
2953 BROAD AVE
MEMPHIS, TN
ZIP 38112
Phone: (901) 271-6061
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CHRIST COMMUNITY HEALTH SERVICES, INC. is a federally qualified health center (fqhc) clinic center in Memphis, TN. CHRIST COMMUNITY HEALTH SERVICES, INC. NPI is 1942788567. The provider is registered as an organization entity type.
The provider Other Name Is Christ Community Dental Outreach.

The provider's business location address is:

2953 BROAD AVE
MEMPHIS, TN
ZIP 38112-957
Phone: (901) 271-6061
Fax: (901) 271-6099

The provider's authorized official is Shantelle Leatherwood .
The authorized official title is Ceo and has the following contact phone number (901) 260-8541.

The enumeration date for this NPI number is 8/6/2018 and was last updated on 8/6/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13707256MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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