Organization Name: | PEOPLE'S COMMUNITY CLINIC, INC. |
NPI Number: | 1083019905 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | REGINA ROGOFF (CEO) |
Mailing Address: | 10335 Us Highway 290 E Manor |
State: | TX US |
Postal Code: | 786534686 |
Phone Number: | 5122784462 |
Fax Number: | 5122784017 |
NPI Enumeration Date: | 11/04/2014 |
NPI Last Update Date: | 05/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |