Organization
PARK DUVALLE COMMUNITY HEALTH CENTER, INC
Active
Parent organization
PARK DUVALLE COMMUNITY HEALTH CENTER, INC
Other names
Henry County Community Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARK DUVALLE COMMUNITY HEALTH CENTER, INC
Authorized official
SWANNIE JETT (CEO)
(502) 774-4401
Entity
Organization
Contact information
Practice address
500 W BROADWAY ST, EMINENCE, KY 40019-1201
(502) 772-5034
Mailing address
3015 WILSON AVE, LOUISVILLE, KY 40211-1969
(502) 774-4401
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31000011
—
KY
05
—
31000920
—
KY
Enumeration date
05/13/2019
Last updated
08/01/2023
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