Organization
VALLEY FAMILY HEATLH CARE, INC
Active
Parent organization
VALLEY FAMILY HEALTH CARE, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VALLEY FAMILY HEALTH CARE, INC
Authorized official
KENNETH ROBERT HART (CEO)
(208) 642-7364
Entity
Organization
Contact information
Practice address
1501 NE 10TH AVE, PAYETTE, ID 83661-5422
(208) 642-9379
(208) 642-5004
Mailing address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 643-9376
(208) 642-9598
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002548900
—
ID
01
—
002549000
HEALTHY CONNECTIONS
ID
05
—
022835
—
OR
01
—
FQHC
COMMUNITY HEALTH CENTER
ID
Enumeration date
07/21/2006
Last updated
02/01/2024
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