Provider Demographics
NPI:1750925293
Name:HEALTH CARE COALITION OF LAFAYETTE COUNTY
Entity type:Organization
Organization Name:HEALTH CARE COALITION OF LAFAYETTE COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TONIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-259-2440
Mailing Address - Street 1:825 S BUSINESS HIGHWAY 13
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64067-1515
Mailing Address - Country:US
Mailing Address - Phone:660-259-2440
Mailing Address - Fax:660-251-0524
Practice Address - Street 1:100 KIRKHAM ST
Practice Address - Street 2:
Practice Address - City:ORRICK
Practice Address - State:MO
Practice Address - Zip Code:64077-8240
Practice Address - Country:US
Practice Address - Phone:877-344-3572
Practice Address - Fax:866-288-4492
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH CARE COALITION OF LAFAYETTE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-28
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)