Organization
WABASH VALLEY HEALTH CENTER, INC.
Active
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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