Russell Neighborood Health Center

LBN: Park Duvalle Community Health Center, Inc.
Russell Neighborood Health Center is an health care organization with primary practice located at 1425 W. Broadway , Louisville KY 40202. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Park Duvalle Community Health Center, Inc. can be contacted via phone (502) 584-2992, or through Jett, Swannie via phone (502) 774-4401.

Contact Information

Primary practice address
1425 W. Broadway Louisville KY 40202
Phone: (502) 584-2992
Fax: (502) 584-3715
Website:
Map and Directions
Authorized official contact:
Name: Jett, Swannie
Phone: (502) 774-4401

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X 700005 Kentucky

Profile Details

NPI number 1255354361
LBN Legal business name Park Duvalle Community Health Center, Inc.
DBA Doing business as Russell Neighborood Health Center
Authorized official Jett, Swannie
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 26th, 2006
Last updated Nov 2nd, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255354361 NPPES
Kentucky MEDICAID 31000011

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