Organization
COMMUNITY HEALTHCARE NETWORK, INC.
Active
Other names
Phoenix School Based Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN J. WENGROFSKY (VICE PRESIDENT OF FINANCE AND CFO)
(212) 545-2439
Entity
Organization
Contact information
Practice address
504 W. 158TH STREET, 5TH FLOOR, ROOM 511, NEW YORK, NY 10032-7202
(917) 521-3130
(917) 521-3108
Mailing address
60 MADISON AVE FL 5, NEW YORK, NY 10010-1600
(212) 545-2439
(646) 312-0481
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
7002119R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00695941
—
NY
Enumeration date
06/05/2017
Last updated
06/05/2017
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