Provider Demographics
NPI:1356567325
Name:COUNTY OF CHEROKEE
Entity type:Organization
Organization Name:COUNTY OF CHEROKEE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:K
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-586-6191
Mailing Address - Street 1:1502 S BOLTON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-3360
Mailing Address - Country:US
Mailing Address - Phone:903-586-6191
Mailing Address - Fax:903-586-3572
Practice Address - Street 1:1502 S BOLTON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-3360
Practice Address - Country:US
Practice Address - Phone:903-586-6191
Practice Address - Fax:903-586-3572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPH0717OtherMEDICARE PTAN
TX130736503Medicaid
TX1356567325Medicaid
TX130736505Medicaid