Organization
ADVOCATES FOR A HEALTHY COMMUNITY INC
Active
Other names
Jordan Valley Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH BROOKS MILLER (PRESIDENT/CEO)
(417) 851-1551
Entity
Organization
Contact information
Practice address
660 S SCENIC AVE, SPRINGFIELD, MO 65802-5072
(417) 851-1558
Mailing address
PO BOX 5681, SPRINGFIELD, MO 65801-5681
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
05/25/2017
Last updated
05/25/2017
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