Organization · Type 2 NPI

Park Duvalle Community Health Center, Inc

Federally Qualified Health Center (FQHC) · Louisville, KY

NPI number 1811545403 Active

Practice location

5901 Greenwood Rd
Louisville, KY 40258-2409

Call (502) 774-4401 Map

Mailing address

3015 Wilson Ave
Louisville, KY 40211-1969

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

2 other providers at this address

Family Health Centers, Inc.Federally Qualified Health Center (FQHC) Louisville, KY NPI 1538093232
Bayleigh HouchinAthletic Trainer Louisville, KY NPI 1417794645

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NPI record

NPI: 1811545403
Entity type: Organization (Type 2)
Issued: Aug 28, 2019
Last updated: Nov 2, 2021
Status: Active
Subpart: Yes of Park Duvalle Community Health Center, Inc

Other names

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Park Duvalle at Pleasure Ridge Park Health Center · doing business as
Park Duvalle at Pleasure Ridge Park Health Center · doing business as

Authorized official

Swannie Jett
CEO
(502) 774-4401

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1811545403

Park Duvalle Community Health Center, Inc's National Provider Identifier is 1811545403, issued on Aug 28, 2019. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Louisville, KY. The record was last updated on Nov 2, 2021.