Provider Demographics
NPI:1144631326
Name:COMMUNITY HEALTH ALLIANCE
Entity type:Organization
Organization Name:COMMUNITY HEALTH ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUDGETING & REVENUE
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-464-4079
Mailing Address - Street 1:1813 W HARVARD AVE
Mailing Address - Street 2:STE 448
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-2752
Mailing Address - Country:US
Mailing Address - Phone:541-464-4079
Mailing Address - Fax:541-440-6306
Practice Address - Street 1:1813 W HARVARD AVE
Practice Address - Street 2:STE 448
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-2752
Practice Address - Country:US
Practice Address - Phone:541-464-4079
Practice Address - Fax:541-440-6306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health