Organization
JANE PAULEY COMMUNITY HEALTH CENTER INC
Active
Organization
JANE PAULEY COMMUNITY HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DALE (CHIEF FINANCE OFFICER)
(317) 934-0755
Entity
Organization
Contact information
Practice address
1503 N MITTHOEFFER RD STE 150, INDIANAPOLIS, IN 46229-2425
(317) 934-0755
(317) 469-1662
Mailing address
1503 N MITTHOEFFER RD STE 150, INDIANAPOLIS, IN 46229-2425
(317) 355-9320
(317) 355-9319
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201026910
—
IN
Enumeration date
03/15/2011
Last updated
01/20/2022
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