Organization
RAPHAEL HEALTH CENTER, INC
Active
Other names
Raphael Health Center - Salvation Army
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL M UTTERBACK (CFO)
(317) 226-4248
Entity
Organization
Contact information
Practice address
711 E WASHINGTON ST, INDIANAPOLIS, IN 46202-3915
(317) 226-4248
Mailing address
401 E 34TH ST, INDIANAPOLIS, IN 46205-3754
(317) 226-4248
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
05/01/2023
Last updated
07/10/2023
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