Grace Community Health Center INC
Clinic/Center, Federally Qualified Health Center (FQHC) in Corbin, KY. Organization (NPI-2).
NPI number1912427675
StatusActive
Last updated in NPPESJun 28, 2024
Details
- NPI
- 1912427675
- Entity type
- Organization (NPI-2)
- Legal business name
- Grace Community Health Center INC
- Organization subpart
- Yes
- Enumeration date
- Jun 23, 2017
- Certification date
- Jun 28, 2024
- Last updated
- Jun 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | 700188 | KY | Yes |
| 103T00000X | Psychologist | – | – | |
| 103TC0700X | Psychologist, Clinical | – | – | |
| 363LF0000X | Nurse Practitioner, Family | 700188 | KY |
Other names
- Corbin Intermediate School Based Health Clinic (Doing Business As)
Practice location
404 W. 17th StreetCorbin, KY 40701-1922
Phone 606-528-1651 · Fax 606-526-8606
Mailing address
1019 Cumberland Falls HwySuite 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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All 18 Federally Qualified Health Center (FQHC) providers in Corbin · All 1,780 providers in Corbin
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