Organization
ADVOCATES FOR A HEALTHY COMMUNITY, INC
Active
Other names
Jordan Valley Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH BROOKS MILLER JR. (CEO)
(417) 851-1551
Entity
Organization
Contact information
Practice address
649 E ELM ST, REPUBLIC, MO 65738-1505
(417) 851-1565
Mailing address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500015254
—
MO
Enumeration date
03/20/2014
Last updated
05/18/2023
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