| Organization Name: | MIDTOWN COMMUNITY HEALTH CENTER INC |
| NPI Number: | 1053780171 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SONJA LEVESQUE (CFO) |
| Mailing Address: | 272 1/2 N Main St Logan |
| State: | UT US |
| Postal Code: | 843213915 |
| Phone Number: | 8013935355 |
| Fax Number: | 8013944609 |
| NPI Enumeration Date: | 09/18/2015 |
| NPI Last Update Date: | 09/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |