Organization Name: | REGIONAL HEALTH CARE CLINIC INC. |
NPI Number: | 1053694422 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTINE STEWART (CEO) |
Mailing Address: | 1109 Clay Street Versailles |
State: | MO US |
Postal Code: | 650841509 |
Phone Number: | 5733782349 |
Fax Number: | 5733782350 |
NPI Enumeration Date: | 09/22/2011 |
NPI Last Update Date: | 04/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |