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Organization

HEART CITY HEALTH CENTER, INC.

Active
Parent organization
HEART CITY HEALTH CENTER, INC.
Other names
Heart City Health Center Scenic Health
Organization subpart
Yes

Provider details

NPI number
Legal business name
HEART CITY HEALTH CENTER, INC.
Authorized official
ESLEEN E FULTZ (CEO)
(574) 970-3257
Entity
Organization

Contact information

Practice address
148 W HIVELY AVE, SUITE 1, ELKHART, IN 46517-2191
(574) 584-7373
(574) 970-3255
Mailing address
236 SIMPSON AVE, ELKHART, IN 46516-4666
(574) 584-7373
(574) 970-3255

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10097610A
IN
Enumeration date
07/28/2014
Last updated
11/03/2023
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