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Organization

TRUSTEES OF PURDUE UNIVERSITY

Active
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Organization

TRUSTEES OF PURDUE UNIVERSITY

Active
Parent organization
PURDUE UNIVERSITY
Other names
Family Health Clinic of Carroll County
Organization subpart
Yes

Provider details

NPI number
Legal business name
PURDUE UNIVERSITY
Authorized official
MR. DANIEL J. LAYMAN (EXECUTIVE DIRECTOR)
(765) 564-3016
Entity
Organization

Contact information

Practice address
901 PRINCE WILLIAM RD, SUITE A, DELPHI, IN 46923-1759
(765) 564-3016
(765) 564-2608
Mailing address
901 PRINCE WILLIAM RD STE A, DELPHI, IN 46923-1759
(765) 564-3016
(765) 564-2608

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200233610A
IN
Enumeration date
09/22/2005
Last updated
07/12/2024
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