Organization
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC
Active
Parent organization
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.
Other names
Birch Grove Health Center- La Clinica
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.
Authorized official
TARA LYNETTE JEANNOT (CHIEF OPERATIONS OFFICER)
(541) 535-6239
Entity
Organization
Contact information
Practice address
910 S CENTRAL AVE, MEDFORD, OR 97501-7822
(541) 618-1380
(541) 618-1385
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127
(541) 535-6239
(541) 842-2212
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022868
—
OR
Enumeration date
02/24/2014
Last updated
07/15/2019
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