TRI-STATE COMMUNITY HEALTHCARE CENTER


Address: 8700 S Highway 95, Mohave Valley, AZ 86440-8519
Phone: 9287687113

TRI-STATE COMMUNITY HEALTHCARE CENTER (NPI# 1841703253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1841703253
Entity Type Organization
Organization Name TRI-STATE COMMUNITY HEALTHCARE CENTER
Practice Address 8700 S Highway 95
Mohave Valley
AZ 86440-8519
Practice Telephone 9287687113
Enumeration Date 2017-11-07
Last Update Date 2017-11-07
Authorized Official Name ARAM MANOUKIAN (CEO)
Authorized Official Telephone 7603260222
Authorized Official Credential CEO
Is Organization Subpart Y
Parent Organization Name TRI-STATE COMMUNITY HEALTHCARE CENTER

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QC1500X Clinic/Center
Specialization: Community Health
Ambulatory Health Care Facilities
N 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1780292839 Tri-state Community Healthcare Center Clinic/Center 11328 Bartlett Ave Ste 3, Adelanto, CA 92301-1913 2020-07-15
1518424274 Tri-state Community Healthcare Center Clinic/Center 1402 Bailey Ave Ste A, Needles, CA 92363-3104 2019-02-28
1922356369 Tri-state Community Healthcare Center Clinic/Center 1402 Bailey Ave, Needles, CA 92363-3104 2012-08-15
1699303628 Tri-state Community Healthcare Center Clinic/Center 4137 Verdugo Rd, Los Angeles, CA 90065-3820 2020-03-27
1952966301 Tri-state Community Healthcare Center Clinic/Center 4137 Verdugo Rd, Los Angeles, CA 90065-3820 2019-05-01
1336646397 Tri-state Community Healthcare Center Clinic/Center 11888 Bartlett Ave, Adelanto, CA 92301-1709 2018-04-06
1023526084 Tri-state Community Healthcare Center Clinic/Center 540 N San Jacinto St Ste P, Hemet, CA 92543-3154 2018-01-11
1508379017 Tri-state Community Healthcare Center Clinic/Center 11888 Bartlett Ave, Adelanto, CA 92301-1709 2017-11-07

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities TRI-STATE COMMUNITY HEALTHCARE CENTER 1402 Bailey Avenue, Needles, CA 92363-3104

Office Location

Street Address 8700 S HIGHWAY 95
City MOHAVE VALLEY
State AZ
Zip Code 86440-8519

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1265784995 Helen M Davis Pharmacist 4810 Egar St, Golden Valley, AZ 86440 2012-10-04
1245461615 Gayle A Brodbeck Student in an Organized Health Care Education/Training Program 1419 E. Willow Dr., Mohave Valley, AZ 86440 2009-08-04
1275798597 Mohave Valley Elementary School District Local Education Agency (LEA) 8450 S. Olive St., Mohave Valley, AZ 86440 2008-07-25
1114010006 Jeffrey Hainlin Miller Family Medicine 1607 Plantation Road, Mohave Valley, AZ 86440 2006-10-02
1568461093 Cynthia Lawrence Physician Assistant 3357 E. Parkside Drive, Mohave Valley, AZ 86440 2005-07-18
1629103775 Lance Ray Surgery 1607 Plantation Road, Mohave Valley, AZ 86440 2007-02-22
1457759284 Brandee Cahill Pharmacist 1607 E Plantation Rd, Mohave Valley, AZ 86440-8420 2014-12-10
1619539269 Amanda Burshia Registered Nurse 1607 E Plantation Rd, Mohave Valley, AZ 86440-8420 2019-07-03
1487126736 Heather Harper Nurse Practitioner 1607 E Plantation Rd, Mohave Valley, AZ 86440-8420 2018-12-27
1225509227 Terri Cirves Pharmacist 1607 E Plantation Rd, Mohave Valley, AZ 86440-8420 2018-12-17
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1306897962 Fort Mojave Indian Tribe Clinic/Center 1607 Plantation Rd, Mohave Valley, AZ 86440-9686 2006-05-16

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1831730795 El Rio Santa Cruz Neighborhood Health Center, Inc Clinic/Center 434 E University Blvd, Tucson, AZ 85705 2019-10-02
1710462593 Chiricahua Community Health Centers, Inc Clinic/Center 310 Arizona St, Bisbee, AZ 85603-1502 2018-09-27
1811472665 Chiricahua Community Health Centers, Inc Clinic/Center 1151 16th Street, Douglas, AZ 85607 2018-09-27
1194207878 Valle Del Sol, Inc. Clinic/Center 1510 S 19th Dr, Phoenix, AZ 85009-6540 2018-08-30
1861970139 Horizon Health and Wellness, Inc. Clinic/Center 374 W Alden Rd, Kearny, AZ 85137-1208 2018-07-30
1578059168 Native Health Clinic/Center 6850 W Indian School Rd Ste Nh1, Phoenix, AZ 85033-3249 2018-07-06
1821582529 Chiricahua Community Health Centers, Inc Clinic/Center 335 South Ocotillo Avenue, Benson, AZ 85602 2018-06-18
1881198992 Valle Del Sol, Inc. Clinic/Center 334 W 10th Pl Ste 100, Mesa, AZ 85201-3499 2018-03-22
1841706785 Circle The City Clinic/Center 206 S 12th Ave, Phoenix, AZ 85007 2017-12-14
1346755295 Circle The City Clinic/Center 210 S 12th Ave, Phoenix, AZ 85007-3101 2017-12-13
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Competitor

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City MOHAVE VALLEY
Zip Code 86440

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Dataset Information

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.

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