Provider Demographics
NPI:1992922769
Name:COMMUNITY HEALTH NEEDS, INC.
Entity type:Organization
Organization Name:COMMUNITY HEALTH NEEDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:EIFLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-827-2765
Mailing Address - Street 1:PO BOX 276
Mailing Address - Street 2:
Mailing Address - City:HOLLANDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38748-0276
Mailing Address - Country:US
Mailing Address - Phone:662-827-2765
Mailing Address - Fax:662-827-5001
Practice Address - Street 1:204 EAST AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:HOLLANDALE
Practice Address - State:MS
Practice Address - Zip Code:38748
Practice Address - Country:US
Practice Address - Phone:662-827-2765
Practice Address - Fax:662-827-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00770261Medicaid