Basic Information
| Provider Information | |||||||||
| NPI: | 1972967313 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY ACTION CORPORATION OF SOUTH TEXAS | ||||||||
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| OtherOrganizationName: | COMMUNITY ACTION INTEGRATION CENTER FALFURRIAS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 204 E 1ST ST | ||||||||
| Address2: | |||||||||
| City: | ALICE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 783324822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3613960370 | ||||||||
| FaxNumber: | 3616642248 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 W POTTS ST | ||||||||
| Address2: | |||||||||
| City: | FALFURRIAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 783554906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3613253673 | ||||||||
| FaxNumber: | 3613252102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2016 | ||||||||
| LastUpdateDate: | 04/13/2016 | ||||||||
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| AuthorizedOfficialLastName: | AWALT | ||||||||
| AuthorizedOfficialFirstName: | ANN | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3613960370 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.