Provider Demographics
NPI:1619330438
Name:CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
Entity Type:Organization
Organization Name:CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NUSRATH
Authorized Official - Middle Name:FATIMA
Authorized Official - Last Name:JAHANGIR
Authorized Official - Suffix:
Authorized Official - Credentials:VN
Authorized Official - Phone:310-962-8970
Mailing Address - Street 1:17695 ARROW BLVD
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-4041
Mailing Address - Country:US
Mailing Address - Phone:323-234-5000
Mailing Address - Fax:323-231-3985
Practice Address - Street 1:17695 ARROW BLVD
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335
Practice Address - Country:US
Practice Address - Phone:310-962-8970
Practice Address - Fax:323-231-3985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)