Organization
JERICHO ROAD MINISTRIES, INC.
Active
Parent organization
JERICHO ROAD MINISTRIES, INC.
Other names
Jericho Road Community Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
JERICHO ROAD MINISTRIES, INC.
Authorized official
JACKIE ENDRESS (CREDENTIALING SPECIALIST)
(716) 348-3000
Entity
Organization
Contact information
Practice address
1021 BROADWAY ST, BUFFALO, NY 14212-1460
(716) 529-3020
(716) 529-3040
Mailing address
184 BARTON ST, BUFFALO, NY 14213-1573
(716) 881-6191
(716) 881-6247
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
1401237R
NY
Other
Enumeration date
06/05/2018
Last updated
08/23/2021
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