Organization
PARK DUVALLE COMMUNITY HEALTH CENTER, INC.
Active
Other names
Taylorsville Community Health Center, Park DuValle at Spencer County
Organization subpart
No
Provider details
NPI number
Authorized official
SWANNIE JETT (CEO)
(502) 774-4401
Entity
Organization
Contact information
Practice address
501 TAYLORSVILLE RD, TAYLORSVILLE, KY 40071-6766
(502) 477-2248
(502) 477-9356
Mailing address
3015 WILSON AVE, LOUISVILLE, KY 40211-1969
(502) 774-4401
(502) 772-4783
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
700005
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31000920
—
KY
Enumeration date
07/28/2006
Last updated
11/02/2021
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