| Open Door Health Services, Inc. | |
|
1912 Jackson St Anderson IN 46016-4336 | |
| (765) 286-7000 | |
| (765) 213-2769 |
| Full Name | Open Door Health Services, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1912 Jackson St, Anderson, Indiana |
| Authorized Official Name and Position | Toni R Estep (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7657472971 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Door Health Services, Inc. 333 S Madison St Muncie IN 47305-2465 Ph: (765) 286-7000 | Open Door Health Services, Inc. 1912 Jackson St Anderson IN 46016-4336 Ph: (765) 286-7000 |
| NPI Number | 1477885465 |
|---|---|
| Provider Enumeration Date | 02/02/2010 |
| Last Update Date | 12/28/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477885465 | NPI | - | NPPES |
| 200167970H | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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