LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC.; NPI #1285000810

Contact Information

LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC.

14678 LAKESHORE BOULEVARD
CLEARLAKE, CA 95453

Phone: 707-262-8382
Fax:
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 LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC.

NPI Number	`1285000810`
LBN Legal business name	LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC.
Authorized official	ERNESTO PADILLA - (EXECUTIVE DIRECTOR)
Entity	Organization
Organization subpart ¹	No
Enumeration date	08/18/2015
Last updated	04/02/2024 - About 2 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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