Provider Demographics
NPI:1902412729
Name:CENTENNIAL HOUSING & COMMUNITY SERVICES CORPORATION
Entity Type:Organization
Organization Name:CENTENNIAL HOUSING & COMMUNITY SERVICES CORPORATION
Other - Org Name:WASHINGTON REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:T
Authorized Official - Last Name:AVIGNONE
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:214-502-9624
Mailing Address - Street 1:7920 BELT LINE RD STE 215
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-8155
Mailing Address - Country:US
Mailing Address - Phone:214-210-9095
Mailing Address - Fax:
Practice Address - Street 1:958 US HIGHWAY 64 E
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NC
Practice Address - Zip Code:27962-9216
Practice Address - Country:US
Practice Address - Phone:252-793-4135
Practice Address - Fax:252-793-7740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty