Organization
OPEN DOOR HEALTH SERVICES, INC.
Active
Other names
Southway Urgent Center
Organization subpart
No
Provider details
NPI number
Authorized official
TONI R ESTEP (CHIEF EXECUTIVE OFFICER)
(765) 281-4257
Entity
Organization
Contact information
Practice address
1651 E 29TH ST, MUNCIE, IN 47302-5886
(765) 286-7000
Mailing address
PO BOX 1676, MUNCIE, IN 47308-1676
(765) 281-4257
(765) 213-2769
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200167970F
—
IN
Enumeration date
06/28/2006
Last updated
05/08/2019
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