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 JR. (EXECUTIVE DIRECTOR)
(417) 831-0150
Entity
Organization
Contact information
Practice address
618 N BENTON AVE, SPRINGFIELD, MO 65806-1102
(417) 831-0150
(417) 831-0155
Mailing address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 851-1551
(417) 831-0155
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400382800
—
MO
05
—
500382809
—
MO
Enumeration date
09/21/2006
Last updated
12/02/2021
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