Organization Name: | UNION COUNTY HEALTH FOUNDATION |
NPI Number: | 1104255389 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRAD R BERTRAND (CEO) |
Mailing Address: | 409 Summit St Suite 3400 Yankton |
State: | SD US |
Postal Code: | 570783735 |
Phone Number: | 6052600310 |
Fax Number: | |
NPI Enumeration Date: | 11/07/2013 |
NPI Last Update Date: | 05/08/2015 |
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: |