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).
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 |
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 |
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 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | TRI-STATE COMMUNITY HEALTHCARE CENTER | 1402 Bailey Avenue, Needles, CA 92363-3104 |
Street Address |
8700 S HIGHWAY 95 |
City | MOHAVE VALLEY |
State | AZ |
Zip Code | 86440-8519 |
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 |
Find all providers in zip 86440 |
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 |
---|---|---|---|---|
1306897962 | Fort Mojave Indian Tribe | Clinic/Center | 1607 Plantation Rd, Mohave Valley, AZ 86440-9686 | 2006-05-16 |
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 |
Find all providers with the same taxonomy |
City | MOHAVE VALLEY |
Zip Code | 86440 |
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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.