Basic Information
Provider Information
NPI: 1649408899
EntityType: 2
ReplacementNPI:  
OrganizationName: COMMUNITY HEALTH PROGRAMS, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CHP NEIGHBORHOOD HEALTH CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P.O. BOX 30
Address2:  
City: GREAT BARRINGTON
State: MA
PostalCode: 01230
CountryCode: US
TelephoneNumber: 4135289311
FaxNumber: 4136440274
Practice Location
Address1: 510 NORTH STREET
Address2:  
City: PITTSFIELD
State: MA
PostalCode: 01201
CountryCode: US
TelephoneNumber: 4134472351
FaxNumber: 4134457009
Other Information
ProviderEnumerationDate: 06/26/2009
LastUpdateDate: 01/17/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SPILIOTES
AuthorizedOfficialFirstName: AMELIA
AuthorizedOfficialMiddleName: J
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 4135289311
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QF0400X  N Ambulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
261QP2300X4COJMAN Ambulatory Health Care FacilitiesClinic/CenterPrimary Care
261QC1500X4COJMAY Ambulatory Health Care FacilitiesClinic/CenterCommunity Health

No ID Information.


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