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General NPI Number Information
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NPI Number | 1467336354
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Entity Type | Organization
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Legal Business Name | ALLIANCE HEALTH CENTERS, INC.
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 5920 DECATUR RD STE 1
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City | FORT WAYNE
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State | IN
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Zip | 46816-3640
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Country | US
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Telephone | 260-266-0780
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Fax | 260-266-0785
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Provider Business Mailing Address
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Address Line | 2700 LAFAYETTE ST STE 110
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City | FORT WAYNE
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State | IN
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Zip | 46806-1100
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Country | US
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Telephone | 260-266-0780
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Fax | 260-266-0785
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Authorized Official
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Title or Position | CEO
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Name | AUTUMAN N. KING
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Credential |
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Telephone | 260-266-0780
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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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