Organization Name: | COMMUNITY HEALTH FOUNDATION OF MAN WV |
NPI Number: | 1184620841 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HERSHEL CHAFIN (CEO) |
Mailing Address: | 600 East Mcdonald Avenue Man |
State: | WV US |
Postal Code: | 256351023 |
Phone Number: | 3045836541 |
Fax Number: | 3045836018 |
NPI Enumeration Date: | 06/27/2005 |
NPI Last Update Date: | 07/17/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |