| NPI | 1053161604 |
|---|---|
| Doing Business As | CHDI HAM LANE |
| Entity Type | Organization |
| Authorized Contact | MAYELA CASTANON CEO 830-278-5604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2025-07-09 |