Organization
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.
Active
Parent organization
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.
Other names
La Clinica School-Based Health Center at Washington Elementary School
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.
Authorized official
TARA LYNETTE JEANNOT (CHIEF OPERATIONS OFFICER)
(541) 535-6239
Entity
Organization
Contact information
Practice address
610 S PEACH ST, MEDFORD, OR 97501
(541) 842-3855
(541) 842-3521
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127
(541) 535-6239
(541) 842-2212
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022868
—
OR
Enumeration date
12/11/2012
Last updated
07/15/2019
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