| Advocates For A Healthy Community, Inc | |
|
2020 Evergreen Pkwy Lebanon MO 65536-4611 | |
| (417) 334-8337 | |
| (417) 832-8275 |
| Full Name | Advocates For A Healthy Community, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2020 Evergreen Pkwy, Lebanon, Missouri |
| Authorized Official Name and Position | Kenneth Brooks Miller (CEO) |
| Authorized Official Contact | 4178511551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advocates For A Healthy Community, Inc 440 E Tampa St Springfield MO 65806-1131 Ph: (417) 831-0150 | Advocates For A Healthy Community, Inc 2020 Evergreen Pkwy Lebanon MO 65536-4611 Ph: (417) 334-8337 |
| NPI Number | 1356032643 |
|---|---|
| Provider Enumeration Date | 05/17/2023 |
| Last Update Date | 05/17/2023 |
| Medicare PECOS PAC ID | 5395653562 |
|---|---|
| Medicare Enrollment ID | O20230802002183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356032643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Advocates For A Healthy Community, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Hoover St, Lebanon, MO 65536 Phone: 417-334-8337 Fax: 417-532-2067 |