Organization Name: | FAMILY CHRISTIAN HEALTH CENTER |
NPI Number: | 1336433382 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LISA J GREEN (CEO) |
Mailing Address: | 713 E 142nd St Dolton |
State: | IL US |
Postal Code: | 604191062 |
Phone Number: | 7085965177 |
Fax Number: | |
NPI Enumeration Date: | 06/07/2011 |
NPI Last Update Date: | 06/07/2011 |
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: |