Provider Demographics
NPI:1740602440
Name:UNION COUNTY HEALTH FOUNDATION
Entity Type:Organization
Organization Name:UNION COUNTY HEALTH FOUNDATION
Other - Org Name:ALLPOINTS ALCESTER DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:BERTRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-356-3317
Mailing Address - Street 1:111 IOWA STREET
Mailing Address - Street 2:
Mailing Address - City:ALCESTER
Mailing Address - State:SD
Mailing Address - Zip Code:57001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 IOWA STREET
Practice Address - Street 2:
Practice Address - City:ALCESTER
Practice Address - State:SD
Practice Address - Zip Code:57001
Practice Address - Country:US
Practice Address - Phone:605-356-3317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNION COUNTY HEALTH FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental