Provider Demographics
NPI:1407463540
Name:COMMUNITY HEALTH ALLIANCE
Entity Type:Organization
Organization Name:COMMUNITY HEALTH ALLIANCE
Other - Org Name:MEDICAL MOBILE VAN
Other - Org Type:Other Name
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-329-6300
Mailing Address - Street 1:680 S ROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-4113
Mailing Address - Country:US
Mailing Address - Phone:775-329-6300
Mailing Address - Fax:
Practice Address - Street 1:680 S ROCK BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4113
Practice Address - Country:US
Practice Address - Phone:775-329-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HEALTH ALLIANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-23
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)