Provider Demographics
NPI:1447614615
Name:CFC HEALTH ASSOCIATES LLC
Entity Type:Organization
Organization Name:CFC HEALTH ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MALCOLM
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAL-CASTANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-675-1931
Mailing Address - Street 1:908 N HOWARD AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-3556
Mailing Address - Country:US
Mailing Address - Phone:308-675-1931
Mailing Address - Fax:308-675-1934
Practice Address - Street 1:908 N HOWARD AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3556
Practice Address - Country:US
Practice Address - Phone:308-675-1931
Practice Address - Fax:308-675-1934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111197363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty