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General NPI Number Information
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NPI Number | 1548891344
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Entity Type | Organization
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Legal Business Name | HEALTHY COMMUNITIES OF CLINTON COUNTY INC
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Dates
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Enumeration Date | 01/30/2020
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 1234 ROSSVILLE AVE STE A
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City | FRANKFORT
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State | IN
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Zip | 46041-1059
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Country | US
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Telephone | 765-659-6063
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Fax |
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Provider Business Mailing Address
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Address Line | 1234 ROSSVILLE AVE STE A
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City | FRANKFORT
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State | IN
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Zip | 46041-1059
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Country | US
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Telephone | 765-659-6063
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LORRA MARIA ARCHIBALD
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Credential |
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Telephone | 765-659-6063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number |
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License Number State |
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