Organization
INFINITY HEALTH
Active
Organization
INFINITY HEALTH
Active
Other names
Behavioral Health Centers of So IA - Chariton
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SAMANTHA CANNON (CEO)
(641) 446-2383
Entity
Organization
Contact information
Practice address
1711 OSCEOLA AVE STE 1200, CHARITON, IA 50049-1516
(641) 774-8484
(641) 774-8485
Mailing address
302 NE 14TH ST, LEON, IA 50144-1206
(641) 446-2383
(641) 446-2382
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
IA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0785352
—
IA
01
—
39014
WELLMARK BLUE CROSS/BLUE SHIELD
—
05
—
500827308
—
MO
Enumeration date
05/23/2007
Last updated
02/11/2022
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