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FQHCLA278B CENTRAL NEIGHBORHOOD HEALTH FOUNDATION (Terminated)
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Main Details
Name
CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
Subdivision Name
Central Neighborhood Health Foundation-Fontana
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-017815
340B ID
FQHCLA278B
Grant Number
LALCS00088
Additional Details
Current Program Status
Terminated
Registration Date
10/4/2016
Participating Start Date
1/1/2017
Participating Approval Date
10/31/2016
Last Recertification Date
1/26/2017
Termination Date
Termination Reason
4/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
Bassett Brown, Chief Executive Officer
(626) 252-5646
Primary Contact
Central Neighborhood Health Foundation
Eleanor Cochran, Chief Administrative Officer
(626) 488-3111
Addresses
Street Address
17695 Arrow Blvd.
Fontana, CA 92335
Billing Address
CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
714 WEST OLYMPIC BLVD
suite 801
LOS ANGELES, CA 90015
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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