| Organization Name: | COMMUNITY HEALTH CONCEPTS - DODGE, LLC |
| NPI Number: | 1326414368 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT TUCKER REED (CEO / MANAGING MEMBER) |
| Mailing Address: | 612 Griffin Ave Eastman |
| State: | GA US |
| Postal Code: | 310236713 |
| Phone Number: | 4785593062 |
| Fax Number: | 4785593035 |
| NPI Enumeration Date: | 08/13/2015 |
| NPI Last Update Date: | 08/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |