Organization
VALLEY FAMILY HEALTH CARE, INC
Active
Parent organization
VALLEY FAMILY HEATLH CARE, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VALLEY FAMILY HEATLH CARE, INC
Authorized official
JENNIFER RODRIGUEZ (PAYER ENROLLMENT SPECIALIST)
(208) 642-9376
Entity
Organization
Contact information
Practice address
17 N 6TH ST, NYSSA, OR 97913-3477
(541) 372-2606
(541) 372-3855
Mailing address
17 N 6TH ST, NYSSA, OR 97913-3477
(541) 372-2606
(541) 372-3855
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
—
002548600
—
ID
05
—
022827
—
OR
01
—
FQHC
COMMUNITY HEALTH CENTER
OR
Enumeration date
07/11/2006
Last updated
07/01/2019
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