Organization
VALLEY FAMILY HEALTH CARE, INC
Active
Parent organization
VALLEY FAMILY HEATLH CARE, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VALLEY FAMILY HEATLH CARE, INC
Authorized official
JENNIFER RODRIGUEZ (PAYER ENROLLMENT SPECIALIST)
(208) 642-9376
Entity
Organization
Contact information
Practice address
2327 SW 4TH AVE, ONTARIO, OR 97914-1851
(541) 889-2340
(541) 889-2593
Mailing address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-9376
(208) 642-9598
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002548700
—
ID
01
—
002549000
HEALTHY CONNECTIONS REF#
ID
05
—
126875
—
OR
01
—
FQHC
COMMUNITY HEALTH CENTER
OR
Enumeration date
06/26/2006
Last updated
05/14/2021
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