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Grace Community Health Center INC

Clinic/Center, Federally Qualified Health Center (FQHC) in Corbin, KY. Organization (NPI-2).

NPI number1801320403
StatusActive
Last updated in NPPESJun 28, 2024

Details

NPI
1801320403
Entity type
Organization (NPI-2)
Legal business name
Grace Community Health Center INC
Organization subpart
Yes
Enumeration date
Apr 20, 2017
Certification date
Jun 28, 2024
Last updated
Jun 28, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC)700188KYYes
103T00000X Psychologist––
103TC0700X Psychologist, Clinical––
207Q00000X Family Medicine––
261QP2300X Clinic/Center, Primary Care––
363A00000X Physician Assistant––
363LF0000X Nurse Practitioner, Family––

Practice location

121 Bishop St
Corbin, KY 40701-1702

Phone 606-528-2124 · Fax 606-528-8272

Mailing address

1019 Cumberland Falls Hwy
Suite B201
Corbin, KY 40701-2735

Phone 606-526-9005 · Fax 606-526-8606

Authorized official

Michael W Stanley
C.E.O.
6065269005

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