Organization Name: | JUNIPER HEALTH, INC |
NPI Number: | 1962823393 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAREN S DITSCH (CEO) |
Mailing Address: | 202 Plummer Street Campton |
State: | KY US |
Postal Code: | 413017879 |
Phone Number: | 6066687385 |
Fax Number: | 6066687009 |
NPI Enumeration Date: | 01/03/2014 |
NPI Last Update Date: | 09/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | 700132A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |