Provider Demographics
NPI:1942759162
Name:COMMUNITY HEALTH PROGRAMS
Entity Type:Organization
Organization Name:COMMUNITY HEALTH PROGRAMS
Other - Org Name:CHP NEIGHBORHOOD DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF HUMAN RESOURCES AND COMPLIANC
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-528-9311
Mailing Address - Street 1:P.O. BOX 30
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230
Mailing Address - Country:US
Mailing Address - Phone:413-528-9311
Mailing Address - Fax:413-644-0274
Practice Address - Street 1:CHP NEIGHBORHOOD DENTAL CENTER
Practice Address - Street 2:510 NORTH STREET. SUITE 2
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-447-2781
Practice Address - Fax:413-395-7922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-29
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM21256Medicare PIN