Provider Demographics
NPI:1073541561
Name:CENTRAL TEXAS COMMUNITY HEALTH CENTERS
Entity Type:Organization
Organization Name:CENTRAL TEXAS COMMUNITY HEALTH CENTERS
Other - Org Name:COMMUNITYCARE-ARCH (AUSTIN RESOURCE CENTER FOR THE HOMELESS)
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:512-978-9811
Mailing Address - Street 1:PO BOX 17366
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78760-7366
Mailing Address - Country:US
Mailing Address - Phone:512-978-9074
Mailing Address - Fax:512-978-9013
Practice Address - Street 1:500 E 7TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-3319
Practice Address - Country:US
Practice Address - Phone:512-978-9920
Practice Address - Fax:512-901-9762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2046658-01Medicaid
TX0A5444Medicare PIN
TX451974Medicare Oscar/Certification