| Community Integrated Health Services, Llc | |
|
1707 Cooks Hill Rd Centralia WA 98531-9071 | |
| (360) 261-6930 | |
| Not Available |
| Full Name | Community Integrated Health Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1707 Cooks Hill Rd, Centralia, Washington |
| Authorized Official Name and Position | Marc Edmund Bollinger (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3607955955 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Integrated Health Services, Llc Po Box 1447 Chehalis WA 98532-0378 Ph: () - | Community Integrated Health Services, Llc 1707 Cooks Hill Rd Centralia WA 98531-9071 Ph: (360) 261-6930 |
| NPI Number | 1942840160 |
|---|---|
| Provider Enumeration Date | 01/15/2020 |
| Last Update Date | 09/27/2022 |
| Certification Date | 09/27/2022 |
| Medicare PECOS PAC ID | 8123403797 |
|---|---|
| Medicare Enrollment ID | O20220917000568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942840160 | NPI | - | NPPES |
| Provider Name | Marc E Bollinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932267283 PECOS PAC ID: 4789670571 Enrollment ID: I20040426000746 |
| Provider Name | Keith A Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861541310 PECOS PAC ID: 7113928615 Enrollment ID: I20070126000043 |
| Provider Name | Jillian L Lotito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962828715 PECOS PAC ID: 1052544483 Enrollment ID: I20230301000473 |
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