Organization
COMMUNITY HEALTH CENTERS, INC.
Active
Organization
COMMUNITY HEALTH CENTERS, INC.
Active
Other names
Central City Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER THOMAS (EXECUTIVE DIRECTOR)
(801) 412-6920
Entity
Organization
Contact information
Practice address
610 S 200 E STE #B, SALT LAKE CITY, UT 84111
(801) 539-8617
(877) 497-4661
Mailing address
1455 W 2200 S STE 300, WEST VALLEY CITY, UT 84119-7219
(801) 412-6920
(877) 497-4661
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316421761
—
UT
Enumeration date
09/21/2018
Last updated
10/30/2023
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