Organization
VALLEY FAMILY HEALTH CARE
Active
Parent organization
VALLEY FAMILY HEALTH CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
VALLEY FAMILY HEALTH CARE
Authorized official
KENNETH ROBERT HART (CEO)
(208) 642-7364
Entity
Organization
Contact information
Practice address
1501 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-9379
Mailing address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-9376
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
06/01/2017
Last updated
02/01/2024
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