| Organization Name: | COMMUNITY HEALTH CENTERS OF SOUTHERN IOWA, INC |
| NPI Number: | 1922294362 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SAMANTHA CANNON (CFO) |
| Mailing Address: | 802 Ackerly St Lamoni |
| State: | IA US |
| Postal Code: | 501401544 |
| Phone Number: | 6417847911 |
| Fax Number: | 6417846162 |
| NPI Enumeration Date: | 09/19/2007 |
| NPI Last Update Date: | 10/31/2012 |
| 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: | |