| Organization Name: | LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC |
| NPI Number: | 1295917862 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRENDA JOHNSON (EXECUTIVE DIRECTOR) |
| Mailing Address: | 4900 Hamrick Road Central Point |
| State: | OR US |
| Postal Code: | 97502 |
| Phone Number: | 5415356239 |
| Fax Number: | |
| NPI Enumeration Date: | 12/05/2007 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |