Organization
GRACE COMMUNITY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL W. STANLEY (C.E.O.)
(606) 526-9005
Entity
Organization
Contact information
Practice address
5923 HIGHWAY 80, WOOTON, KY 41776-8840
(606) 526-9005
(606) 526-8606
Mailing address
5923 HWY 80, WOOTON, KY 41776-0000
(606) 526-9005
(606) 526-8606
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
KY
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
KY
261QP2300X
Primary Care Clinic/Center
700188
KY
363L00000X
Nurse Practitioner
—
KY
Other
Enumeration date
08/07/2012
Last updated
06/28/2024
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