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Organization

TRUSTEES OF PURDUE UNIVERSITY

Active
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Organization

TRUSTEES OF PURDUE UNIVERSITY

Active
Parent organization
PURDUE UNIVERSITY
Other names
Family Health Clinic of Monon
Organization subpart
Yes

Provider details

NPI number
Legal business name
PURDUE UNIVERSITY
Authorized official
MR. DANIEL J LAYMAN (EXECUTIVE DIRECTOR)
(765) 564-3016
Entity
Organization

Contact information

Practice address
692 E BROADWAY ST, MONON, IN 47959-8191
(877) 797-2404
Mailing address
PO BOX 597, DELPHI, IN 46923-0597
(765) 564-3016
(765) 564-2608

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200852780A
IN
Enumeration date
05/29/2007
Last updated
07/12/2024
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