Provider Demographics
NPI:1114761996
Name:ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES
Entity type:Organization
Organization Name:ANDERSON CHEROKEE COMMUNITY ENRICHMENT SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:STROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-541-2577
Mailing Address - Street 1:1011 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-3307
Mailing Address - Country:US
Mailing Address - Phone:903-541-2577
Mailing Address - Fax:903-586-9200
Practice Address - Street 1:597 S RAGSDALE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-2434
Practice Address - Country:US
Practice Address - Phone:903-589-0990
Practice Address - Fax:903-586-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty