Organization
ALLIANCE HEALTH CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE LOCKHART MHA, PHR (CEO)
(260) 266-0780
Entity
Organization
Contact information
Practice address
2700 LAFAYETTE ST STE 110, FORT WAYNE, IN 46806-1100
(812) 230-5150
Mailing address
2700 LAFAYETTE ST STE 110, FORT WAYNE, IN 46806-1100
(260) 266-0780
(260) 266-0785
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300043694
—
IN
Enumeration date
07/30/2020
Last updated
06/10/2024
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