Provider Demographics
NPI:1164092979
Name:CENTERPLACE HEALTH, INC.
Entity Type:Organization
Organization Name:CENTERPLACE HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-529-0243
Mailing Address - Street 1:1750 17TH ST STE N
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-8690
Mailing Address - Country:US
Mailing Address - Phone:941-529-0203
Mailing Address - Fax:855-674-1836
Practice Address - Street 1:1750 17TH ST STE E
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-8666
Practice Address - Country:US
Practice Address - Phone:941-529-0200
Practice Address - Fax:855-674-1836
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTERPLACE HEALTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)