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LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC. NPI 1821572884


NPI Information

NPI: 1821572884
Provider Name: LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.

Doing Business As: LA CLINICA SCHOOL-BASED HEALTH CENTER AT SAM'S VALLEY ELEMENTARY SCHOO

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 38D2154181

Address:
14235 TABLE ROCK RD
CENTRAL POINT, OR
ZIP 97502
Phone: (541) 494-6818
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LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC. is a federally qualified health center (fqhc) clinic center in Central Point, OR. LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC. NPI is 1821572884. The provider is registered as an organization entity type.
The provider Is Doing Business As La Clinica School-based Health Center At Sam's Valley Elementary Schoo.

The provider's business location address is:

14235 TABLE ROCK RD
CENTRAL POINT, OR
ZIP 97502-377
Phone: (541) 494-6818
Fax: (541) 494-6816

The provider's authorized official is Tara Lynette Jeannot .
The authorized official title is Chief Operations Officer and has the following contact phone number (541) 535-6239.

The CLIA number assigned to this NPI record is 38D2154181 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/17/2018 and was last updated on 7/15/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1022868MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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