Organization
WABASH VALLEY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER C. CIANCONE (PRESIDENT OF THE BOARD OF DIRECTORS)
(812) 240-6056
Entity
Organization
Contact information
Practice address
1436 LOCUST ST, TERRE HAUTE, IN 47807-1648
(812) 232-7447
Mailing address
1436 LOCUST ST, TERRE HAUTE, IN 47807-1648
(812) 232-7447
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201168600A
—
IN
Enumeration date
12/12/2013
Last updated
06/25/2020
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