| Christian Activity Health Center | |
|
540 N 6th St East Saint Louis IL 62201-1320 | |
| (618) 397-3303 | |
| (618) 397-3303 |
| Full Name | Christian Activity Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 540 N 6th St, East Saint Louis, Illinois |
| Authorized Official Name and Position | Larry Mcculley (COO) |
| Authorized Official Contact | 6183320694 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Christian Activity Health Center 8080 State St East Saint Louis IL 62203-1808 Ph: (618) 397-3303 | Christian Activity Health Center 540 N 6th St East Saint Louis IL 62201-1320 Ph: (618) 397-3303 |
| NPI Number | 1619127289 |
|---|---|
| Provider Enumeration Date | 09/19/2008 |
| Last Update Date | 09/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619127289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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