Provider Demographics
NPI:1710915897
Name:ADAMS COUNTY HEALTH CENTER INC
Entity Type:Organization
Organization Name:ADAMS COUNTY HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LANGSTON-GROVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-253-4242
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:COUNCIL
Mailing Address - State:ID
Mailing Address - Zip Code:83612-0428
Mailing Address - Country:US
Mailing Address - Phone:208-253-4242
Mailing Address - Fax:208-253-6849
Practice Address - Street 1:205 N BERKLEY
Practice Address - Street 2:
Practice Address - City:COUNCIL
Practice Address - State:ID
Practice Address - Zip Code:83612-0428
Practice Address - Country:US
Practice Address - Phone:208-253-4242
Practice Address - Fax:208-253-6849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1700100OtherCIGNA
ID1700101OtherCIGNA
ID807150400Medicaid
ID807150400Medicaid
ID131827Medicare Oscar/Certification