| Organization Name: | COMMUNITY HEALTH CENTERS OF SOUTHERN IOWA, INC |
| NPI Number: | 1194941542 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SAMANTHA CANNON (CFO) |
| Mailing Address: | 12 Washington Ave West Albia |
| State: | IA US |
| Postal Code: | 525312030 |
| Phone Number: | 6419322065 |
| Fax Number: | 6419322365 |
| NPI Enumeration Date: | 04/17/2007 |
| NPI Last Update Date: | 11/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |