Provider Demographics
NPI:1235351776
Name:COMMUNITY HEALTH DEVELOPMENT, INC.
Entity Type:Organization
Organization Name:COMMUNITY HEALTH DEVELOPMENT, INC.
Other - Org Name:OUR HEALTH - UMH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAYELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-278-5604
Mailing Address - Street 1:908 EVANS ST
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-6034
Mailing Address - Country:US
Mailing Address - Phone:830-278-5604
Mailing Address - Fax:830-278-1836
Practice Address - Street 1:200 EVANS ST
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-5142
Practice Address - Country:US
Practice Address - Phone:830-278-5604
Practice Address - Fax:830-278-1836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXZ00FM205261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1114381-07Medicaid