Provider Demographics
NPI:1285630533
Name:COMMUNITY HEALTH CONNECTIONS, INC.
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CONNECTIONS, INC.
Other - Org Name:GARDNER COMMUNITY HEALTH CONNECTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEMALIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-878-8510
Mailing Address - Street 1:326 NICHOLS ROAD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-1914
Mailing Address - Country:US
Mailing Address - Phone:978-878-8100
Mailing Address - Fax:978-878-8418
Practice Address - Street 1:175 CONNORS STREET
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-2637
Practice Address - Country:US
Practice Address - Phone:978-410-6100
Practice Address - Fax:978-410-6109
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HEALTH CONNECTIONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-22
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QC1500X
NH30214981261QC1500X
MA4L4L261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH261QC1500XOtherMEDICAID OF NEW HAMPSHIRE
MA1320815Medicaid
NH261QC1500XOtherMEDICAID OF NEW HAMPSHIRE
MAM21400Medicare Oscar/Certification
MA1320815Medicaid