Organization
RAPHAEL HEALTH CENTER, INC
Active
Organization
RAPHAEL HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HOAGLAND C. ELLIOTT (EXECUTIVE DIRECTOR)
(317) 926-1507
Entity
Organization
Contact information
Practice address
401 E 34TH ST, INDIANAPOLIS, IN 46205
(317) 926-1507
(317) 926-1508
Mailing address
401 E 34TH ST, INDIANAPOLIS, IN 46205-3754
(317) 926-1507
(317) 926-1508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01051367A
IN
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200077460A
—
IN
Enumeration date
08/30/2006
Last updated
07/26/2018
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