Provider Demographics
| NPI: | 1558181487 |
|---|---|
| Name: | COMMUNITY HEALTH PROGRAMS, INC |
| Entity type: | Organization |
| Organization Name: | COMMUNITY HEALTH PROGRAMS, INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | BETHANY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | KIELEY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 413-528-9311 |
| Mailing Address - Street 1: | PO BOX 30 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | GREAT BARRINGTON |
| Mailing Address - State: | MA |
| Mailing Address - Zip Code: | 01230-0030 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 413-528-9311 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 444 STOCKBRIDGE RD |
| Practice Address - Street 2: | |
| Practice Address - City: | GREAT BARRINGTON |
| Practice Address - State: | MA |
| Practice Address - Zip Code: | 01230-1295 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 413-528-9311 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2024-10-15 |
| Last Update Date: | 2024-10-15 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261QD0000X | Ambulatory Health Care Facilities | Clinic/Center | Dental |
| No | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |