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General NPI Number Information
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NPI Number | 1083009997
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Entity Type | Organization
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Legal Business Name | VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC
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Dates
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Enumeration Date | 03/30/2015
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Last Update Date | 12/17/2018
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Provider Practice Location Address
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Address Line | 1702 LAFAYETTE RD
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-1033
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Country | US
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Telephone | 765-625-5100
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Fax | 765-281-1030
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Provider Business Mailing Address
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Address Line | 1702 LAFAYETTE RD
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-1033
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Country | US
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Telephone | 765-625-5100
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Fax | 765-281-1030
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Authorized Official
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Title or Position | CEO
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Name | TERRY WARREN
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Credential |
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Telephone | 260-969-6598
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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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