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Contact Information

LAKESHORE COMMUNITY HEALTH CARE, INC
908 W WASHINGTON ST
WEST BEND, WI53095-2430
 Phone: 920-783-6633
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
Indicates primary specialty

NPI Profile & details for LAKESHORE COMMUNITY HEALTH CARE, INC

NPI # 1184358004
LBN Legal business name LAKESHORE COMMUNITY HEALTH CARE, INC
Authorized official CALEB JENSEMA - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 07/15/2022
Last updated 07/15/2022 - About 4 years ago
Identifiers n/a
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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