| NPI | 1700213790 |
|---|---|
| Doing Business As | PACES CREEK ELEMENTARY SCHOOL BASED CLINIC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL W. STANLEY Credentialing 606-526-9005 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: KY 700188) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: KY 700188) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 700188) | |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2024-06-28 |