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General NPI Number Information
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NPI Number | 1043396005
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Entity Type | Organization
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Legal Business Name | INDIAN HEALTH COUNCIL, INC.
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 110 1/2 SCHOOL HOUSE CANYON ROAD
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City | SANTA YSABEL
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State | CA
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Zip | 92070
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Country | US
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Telephone | 760-765-4203
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Fax |
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Provider Business Mailing Address
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Address Line | P O BOX 406
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City | PAUMA VALLEY
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State | CA
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Zip | 92061
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Country | US
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Telephone | 760-749-1410
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Fax | 760-749-4239
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Authorized Official
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Title or Position | PATIENT MANAGEMENT DIRECTOR
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Name | BETH TURNER
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Credential | MPH
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Telephone | 760-749-1410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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