TRI-STATE COMMUNITY HEALTHCARE CENTER (NPI# 1922356369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922356369 |
| Entity Type | Organization |
| Organization Name | TRI-STATE COMMUNITY HEALTHCARE CENTER |
| Practice Address |
1402 Bailey Ave Needles CA 92363-3104 |
| Practice Telephone | 7603260222 |
| Practice Fax Number | 7603260221 |
| Mailing Telephone | 7603260222 |
| Mailing Fax Number | 7603260221 |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2016-03-24 |
| Authorized Official Name | ARAM MANOUKIAN (CEO) |
| Authorized Official Telephone | 8186526612 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
CA | Ambulatory Health Care Facilities | |
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780292839 | Tri-state Community Healthcare Center | Clinic/Center | 11328 Bartlett Ave Ste 3, Adelanto, CA 92301-1913 | 2020-07-15 |
| 1518424274 | Tri-state Community Healthcare Center | Clinic/Center | 1402 Bailey Ave Ste A, Needles, CA 92363-3104 | 2019-02-28 |
| 1841703253 | Tri-state Community Healthcare Center | Clinic/Center | 8700 S Highway 95, Mohave Valley, AZ 86440-8519 | 2017-11-07 |
| 1699303628 | Tri-state Community Healthcare Center | Clinic/Center | 4137 Verdugo Rd, Los Angeles, CA 90065-3820 | 2020-03-27 |
| 1952966301 | Tri-state Community Healthcare Center | Clinic/Center | 4137 Verdugo Rd, Los Angeles, CA 90065-3820 | 2019-05-01 |
| 1336646397 | Tri-state Community Healthcare Center | Clinic/Center | 11888 Bartlett Ave, Adelanto, CA 92301-1709 | 2018-04-06 |
| 1023526084 | Tri-state Community Healthcare Center | Clinic/Center | 540 N San Jacinto St Ste P, Hemet, CA 92543-3154 | 2018-01-11 |
| 1508379017 | Tri-state Community Healthcare Center | Clinic/Center | 11888 Bartlett Ave, Adelanto, CA 92301-1709 | 2017-11-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | TRI-STATE COMMUNITY HEALTHCARE CENTER | 1402 Bailey Avenue, Needles, CA 92363-3104 |
| Street Address |
1402 BAILEY AVE |
| City | NEEDLES |
| State | CA |
| Zip Code | 92363-3104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972158624 | Nicole Ann Roberts | Nurse Practitioner | 1402 Bailey Ave, Needles, CA 92363-3104 | 2019-08-08 |
| 1316484074 | Lateshia Henderson | Nurse Practitioner | 1402 Bailey Ave, Needles, CA 92363-3104 | 2017-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396022026 | Dhhs Ihs Phoenix Area | Clinic/Center | 1900 Palo Verde, Havasu Lake, CA 92363 | 2011-11-09 |
| 1457520942 | Community Healthcare Partner, Inc | Emergency Medicine | 1401 Bailey Avenue, Needles, CA 92363 | 2008-02-28 |
| 1457478075 | Lake Havasu Fire District | Ambulance | 148808 Havasu Lake Rd, Lake Havasu, CA 92363 | 2007-03-26 |
| 1871070672 | David Rubio | Counselor | 1600 Bailey Ave Ste 2, Needles, CA 92363 | 2018-07-24 |
| 1205035862 | Donald Anderson | Counselor | 640 California Ave, Needles, CA 92363-2115 | 2007-07-13 |
| 1578642815 | Jerry Neil South | Chiropractor | 1400 Needles Hwy, Ste. 105, Needles, CA 92363-2364 | 2006-11-06 |
| 1437145299 | Willow Valley Pharmacy, Inc., Dba | Pharmacy | 1101 W Broadway St, Needles, CA 92363-2704 | 2005-09-26 |
| 1417426578 | Needles Hospice, Inc. | Hospice Care, Community Based | 813 W Broadway St Unit B, Needles, CA 92363-2727 | 2018-11-19 |
| 1598397960 | Billet Adhc Inc Needles | Clinic/Center | 901 Front St, Needles, CA 92363-2739 | 2020-02-04 |
| 1821126889 | Mental Health Systems, Inc. | Community/Behavioral Health | 300 H St, Needles, CA 92363-2928 | 2007-03-01 |
| Find all providers in zip 92363 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555061 | Pacific Central Coast Health Centers | Clinic/Center | 1560 Mesa Rd, Ste 101, Nipomo, CA 93444 | 2020-10-15 |
| 1891301578 | Vida Community Clinic | Clinic/Center | 1519 Woodworth St, San Fernando, CA 91340-4153 | 2020-09-18 |
| 1982210522 | Life Helping Hands Inc | Clinic/Center | 987 Haley Talbert Dr, Corona, CA 92881-8402 | 2020-09-18 |
| 1780292912 | Marin Community Clinic | Clinic/Center | 1260 S Eliseo Dr Ste 201, Greenbrae, CA 94904-2009 | 2020-07-14 |
| 1922625847 | Gardner Family Health Network | Clinic/Center | 1621 Gold St, Alviso, CA 95002-3530 | 2020-06-26 |
| 1194340794 | Greenville Rancheria | Clinic/Center | 13545 Saint Marys Ave, Red Bluff, CA 96080-8884 | 2020-06-10 |
| 1841829876 | Pacific Central Coast Health Centers | Clinic/Center | 1992 Old Mission Dr Ste 140, Solvang, CA 93463-2302 | 2020-04-02 |
| 1740812866 | Tauna Mcginnis | Clinic/Center | 1570 Soquel Dr Ste 4, Santa Cruz, CA 95065-1715 | 2020-02-06 |
| 1275173403 | United Advocates for Children and Families | Clinic/Center | 2143 Hurley Way Ste 102, Sacramento, CA 95825-3297 | 2020-01-15 |
| 1083251532 | Prime Wellness Community Health Center | Clinic/Center | 1824 1/2 W 38th Pl, Los Angeles, CA 90062-1012 | 2019-12-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.