Provider Demographics
NPI:1316677404
Name:VALLE FAMILY CARE LLC
Entity type:Organization
Organization Name:VALLE FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-706-7537
Mailing Address - Street 1:134 S COCHRAN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-1557
Mailing Address - Country:US
Mailing Address - Phone:517-485-0001
Mailing Address - Fax:
Practice Address - Street 1:134 S COCHRAN AVE STE B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1557
Practice Address - Country:US
Practice Address - Phone:517-485-0001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty