| Organization Name: | LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC |
| NPI Number: | 1215328232 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRENDA JOHNSON (CEO) |
| Mailing Address: | 450 S 4th St Central Point |
| State: | OR US |
| Postal Code: | 975022224 |
| Phone Number: | 5415356239 |
| Fax Number: | 5415121026 |
| NPI Enumeration Date: | 02/12/2015 |
| NPI Last Update Date: | 02/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |