Organization
INDIANOLA CLINIC, LLC
Active
Organization
INDIANOLA CLINIC, LLC
Active
Parent organization
DELTA HEALTH ALLIANCE, INC.
Other names
Leland Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
DELTA HEALTH ALLIANCE, INC.
Authorized official
AMY MCINTIRE (DIRECTOR)
(662) 686-3956
Entity
Organization
Contact information
Practice address
201 BAKER BLVD, LELAND, MS 38756-3401
(662) 686-4121
(662) 686-4770
Mailing address
201 BAKER BLVD, LELAND, MS 38756-3401
(662) 686-4121
(662) 686-4770
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016086
—
MS
05
—
200005767
—
MS
Enumeration date
09/25/2006
Last updated
07/08/2026
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