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CHC10608-15 CENTRAL CITY COMMUNITY HEALTH CENTER, INC. (Terminated)
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Main Details
Name
CENTRAL CITY COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Central City Community Health Center-Indio
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014681
340B ID
CHC10608-15
Grant Number
H80CS10608
Additional Details
Current Program Status
Terminated
Registration Date
10/6/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/21/2015
Last Recertification Date
3/3/2016
Termination Date
Termination Reason
1/1/2017
Site closure
Contacts
Authorizing Official
Casey A. Fatch, Chief Executive Officer
(323) 724-0019 Ext: 1012
Primary Contact
Dominic Martinez, Director of Clinic Operations
(323) 724-0019 Ext: 1014
Addresses
Street Address
82-420 MILES AVE
INDIO, CA 92201-4250
Billing Address
Central City Community Health Center, Inc. - Admin
5233 E. Beverly Blvd
Los Angeles, CA 90022-2020
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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