NPIMap

Organization Active NPI

Henry J Austin Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Trenton, NJ
National Provider Identifier
1710161823
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
22310 Issued in NJ
Legal business name
HENRY J AUSTIN HEALTH CENTER, INC
Practice address
317 Chambers St
Trenton, NJ 08609-2603
Phone
(609) 392-2635
Fax
(609) 695-3532
NPI assigned
Dec 26, 2007
Last updated
Sep 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Charles L Davis II
Title
Ceo
Phone
(609) 278-5970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 22310 NJ Primary

Addresses

Primary practice location

317 Chambers St
Trenton, NJ 08609-2603

Mailing address

321 N Warren St
Trenton, NJ 08618-4741
Phone (609) 278-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040720001145 NJ Part A Provider - Federally Qualified Health Center (FQHC) 9739179409 Practice locations: Trenton, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710161823. Details of each certification follow.

Federally qualified health center certification: CCN 311831

Legal name
HENRY J AUSTIN HEALTH CENTER, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 12, 1994
Last certification
Sep 12, 1994
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Feb 19, 1986 in NJ
Enrollment address
317 Chambers St
Trenton, NJ 86092603
Related CCNs
311801

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Henry J Austin Health Center at Family Guidance Center Corporation13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

314 E State St
Trenton, NJ 08608
Phone (609) 396-4258

321 N Warren St
Trenton, NJ 08618
Phone (609) 278-6029

433 Bellevue Ave
Fl 4
Trenton, NJ 08618
Phone (609) 278-6029

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Alfonso Llano Individual Corporate DirectorBoard Member Jun 1, 2018
Detravius Bethea Individual Corporate DirectorBoard Member Jun 1, 2017
Nancy Perez Individual W-2 Managing EmployeeProvider Enrollment & Credentialing Dec 22, 2014
Kemi a Alli Individual Corporate OfficerChief Executive Officer Jun 12, 2017
Corporate DirectorCeo Jun 12, 2017
Operational/Managerial Control Jun 12, 2017 100%
Beverly a Smith Individual Corporate DirectorBoard Member Jun 1, 2017
Laurence Ganges Individual Corporate DirectorBoard Member Jun 1, 2018
Chinweze N Ahagotu Individual Corporate DirectorBoard Member Jun 1, 2018
Daniel R Benson Individual Corporate DirectorBoard Member Jun 1, 2017
Tyrone Gaskins Individual Corporate DirectorBoard Member Jun 1, 2017
Charles L Davis Individual Corporate DirectorBoard Member Jun 1, 2017

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1710161823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N WARREN ST",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086184741",
            "telephone_number": "609-278-5900",
            "fax_number": "609-695-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 CHAMBERS ST",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086092603",
            "telephone_number": "609-392-2635",
            "fax_number": "609-695-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY J AUSTIN HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-278-5970",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "22310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.