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General NPI Number Information
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NPI Number | 1972312973
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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 | 01/03/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 1792 E STATE ROAD 163
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City | CLINTON
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State | IN
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Zip | 47842-7327
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Country | US
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Telephone | 765-828-3241
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Fax |
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Provider Business Mailing Address
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Address Line | 777 S MAIN ST STE 100
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City | CLINTON
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State | IN
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Zip | 47842-2493
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Country | US
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Telephone | 765-828-1003
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Fax | 765-828-1030
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | TERRY J WARREN
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Credential |
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Telephone | 765-828-1003
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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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