Provider Demographics
NPI:1811475346
Name:COMMUNITY HEALTH 1ST ER, LLC
Entity type:Organization
Organization Name:COMMUNITY HEALTH 1ST ER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTENEH
Authorized Official - Middle Name:
Authorized Official - Last Name:BELAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-225-4293
Mailing Address - Street 1:9870 GAYLORD DR APT 1006
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1101 EAST BLVD
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-1909
Practice Address - Country:US
Practice Address - Phone:281-306-5180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-06
Last Update Date:2019-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care