Provider Demographics
NPI:1073970141
Name:ELLIS COUNTY COALITION FOR HEALTH OPTIONS
Entity Type:Organization
Organization Name:ELLIS COUNTY COALITION FOR HEALTH OPTIONS
Other - Org Name:HOPE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-923-2440
Mailing Address - Street 1:805 W LAMPASAS ST
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-4535
Mailing Address - Country:US
Mailing Address - Phone:972-923-2440
Mailing Address - Fax:972-923-2445
Practice Address - Street 1:805 W LAMPASAS ST
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-4535
Practice Address - Country:US
Practice Address - Phone:972-923-2440
Practice Address - Fax:972-923-2445
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELLIS COUNTY COALITION FOR HEALTH OPTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-20
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)