COMMUNITY HEALTH CENTER OF LUBBOCK, INC (NPI# 1831118306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831118306 |
| Entity Type | Organization |
| Organization Name | COMMUNITY HEALTH CENTER OF LUBBOCK, INC |
| Other Organization Name | CHCL COMMUNITY DENTAL CLINIC |
| Practice Address |
1826 Parkway Dr Suite 500 Lubbock TX 79403 |
| Mailing Address |
1610 5th St Lubbock TX 79401-2622 |
| Practice Telephone | 8066876259 |
| Practice Fax Number | 8067710850 |
| Mailing Telephone | 8067652611 |
| Mailing Fax Number | 8066875826 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2018-05-29 |
| Authorized Official Name | MR. MICHAEL P. SULLIVAN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 8067652611 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 019021712 | 05 |
| Other Name | Type Code |
|---|---|
| CHCL Community Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891768321 | Community Health Center of Lubbock, Inc | Clinic/Center | 406 Mlk Blvd, Lubbock, TX 79403 | 2006-02-07 |
| 1548231046 | Community Health Center of Lubbock, Inc | Clinic/Center | 1610 5th St, Lubbock, TX 79401 | 2006-02-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY HEALTH CENTER OF LUBBOCK, INC., THE | 1610 5th St, Lubbock, TX 79401-2622 |
| Street Address |
1826 PARKWAY DR SUITE 500 |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013306133 | Innovative Dialysis Center of Lubbock, LLC | Clinic/Center | 1826 Parkway Dr, Lubbock, TX 79403-4406 | 2015-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205484987 | Keisha Jones | Nurse Practitioner | 1406 Quinlan St, Lubbock, TX 79403 | 2019-08-27 |
| 1710254701 | Todd Patrick Faison | Specialist/Technologist | 1504 E. Itasca Ave., Lubbock, TX 79403 | 2011-11-19 |
| 1336341254 | Jerry Wade Lee | Pharmacist | 1950 Aspen, Lubbock, TX 79403 | 2007-06-04 |
| 1982726832 | The Adult Day Activity Center of Lubbock, Inc. | Clinic/Center | 2807 42nd Street, Lubbock, TX 79403 | 2007-04-04 |
| 1891768321 | Community Health Center of Lubbock, Inc | Clinic/Center | 406 Mlk Blvd, Lubbock, TX 79403 | 2006-02-07 |
| 1649425851 | Sue C Craig | Physical Therapy Assistant | 208 Country Club Dr, Lubbock, TX 79403-1010 | 2008-12-02 |
| 1447310834 | Arthur Richard Howard Jr. | Dentist | 1109 Kemper St, Lubbock, TX 79403-2523 | 2006-12-08 |
| 1316150626 | Deborah Isaacks | Registered Nurse | 1109 Kemper St, Lubbock, TX 79403-2523 | 2007-05-07 |
| 1588118376 | Joseph Jordan | Contractor | 2001 Kent St, Lubbock, TX 79403-2922 | 2016-08-09 |
| 1902936545 | Robert Alan Ramos I | Specialist/Technologist | 1504 E Itasca St, Lubbock, TX 79403-3120 | 2007-03-06 |
| Find all providers in zip 79403 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831569540 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3502 9th St Ste 280, Lubbock, TX 79415 | 2015-10-07 |
| 1750702015 | Texas Tech University Health Sciences Center Son | Clinic/Center | 2424 50th St Rm 300, Lubbock, TX 79412-2561 | 2014-01-03 |
| 1225304686 | Community Health Center of Lubbock, Inc. | Clinic/Center | 5424 19th St Ste 200, Lubbock, TX 79407 | 2012-03-29 |
| 1740551787 | Community Health Center of Lubbock, Inc. | Clinic/Center | 2401 Fulton Ave Apt B, Lubbock, TX 79407-7727 | 2012-01-23 |
| 1912944059 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3301 Clovis Road, Lubbock, TX 79415 | 2006-05-31 |
| 1891768321 | Community Health Center of Lubbock, Inc | Clinic/Center | 406 Mlk Blvd, Lubbock, TX 79403 | 2006-02-07 |
| 1528030087 | Community Health Center of Lubbock, Inc. | Clinic/Center | 2301 Cedar Ave, Lubbock, TX 79404 | 2006-02-07 |
| 1093269904 | Community Health Clinic Lubbock | Clinic/Center | 1610 5th St, Lubbock, TX 79401-2622 | 2016-08-09 |
| 1407116304 | South Plains Rural Health Services, Inc | Clinic/Center | 2424 50th St, Suite 204, Lubbock, TX 79412-2549 | 2012-05-24 |
| 1609023191 | Texas Tech University Health Sciences Center - Son - Lubbock | Clinic/Center | 301 40th St, Lubbock, TX 79404-2811 | 2008-08-26 |
| Find all providers in LUBBOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.