THE LAKES COMMUNITY HEALTH CENTER, INC; NPI #1083961163

Contact Information

THE LAKES COMMUNITY HEALTH CENTER, INC

600 W SHELL CREEK RD
MINONG, WI 54859-9302

Phone: 715-466-2201
Fax: 715-466-2205
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center

Indicates primary specialty

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NPI Profile & details for THE LAKES COMMUNITY HEALTH CENTER, INC

NPI Number 1083961163

LBN Legal business name THE LAKES COMMUNITY HEALTH CENTER, INC

Authorized official REBA RICE - (CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/08/2012

Last updated 08/05/2021 - About 5 years ago

Identifiers

WI	License #	26972
WI	Medicaid	1811178825

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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