Organization
PEOPLES COMMUNITY HEALTH CLINIC, INC
Active
Parent organization
PEOPLES COMMUNITY HEALTH CLINIC, INC
Other names
Success Street - Carver Academy
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEOPLES COMMUNITY HEALTH CLINIC, INC
Authorized official
BETH WHITE (HR ADMINISTRATOR)
(319) 874-3000
Entity
Organization
Contact information
Practice address
1505 LOGAN AVE, WATERLOO, IA 50703-1910
(319) 433-2500
Mailing address
905 FRANKLIN ST, WATERLOO, IA 50703-4407
(319) 874-3000
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076372
—
IA
01
—
15689
WELLMARK BLUE CROSS AND BLUE SHIELD
IA
Enumeration date
10/25/2021
Last updated
10/25/2021
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