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General NPI Number Information
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NPI Number | 1962325308
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Entity Type | Organization
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Legal Business Name | HEALTHCORE CLINIC INC
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 4852 S BROADWAY AVE
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City | WICHITA
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State | KS
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Zip | 67216-3713
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Country | US
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Telephone | 316-691-0249
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Fax | 877-803-1562
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Provider Business Mailing Address
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Address Line | 2707 E 21ST ST N
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City | WICHITA
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State | KS
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Zip | 67214-2249
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Country | US
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Telephone | 316-691-0249
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Fax | 877-803-1562
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Authorized Official
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Title or Position | CEO
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Name | TERESA LOVELADY
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Credential |
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Telephone | 316-691-0249
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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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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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