National Provider Identifier Database

LAKE SUPERIOR COMMUNITY HEALTH CENTER
Federally Qualified Health Center (FQHC)

A Federally Qualified Health Center (FQHC) is a community-based organization that provides comprehensive primary care and preventive care, including health, oral, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status.


Contact Information

LAKE SUPERIOR COMMUNITY HEALTH CENTER
1500 N 34TH ST STE 200
SUPERIOR, WI54880-4477
Phone: 715-395-5380
Fax: 715-394-2682
Website:
Specialty Taxonomy Code
* Federally Qualified Health Center (FQHC) 261QF0400X

* Indicates primary specialty

NPI Profile & details for LAKE SUPERIOR COMMUNITY HEALTH CENTER

NPI Number 1639684384
Legal business name
LBN
LAKE SUPERIOR COMMUNITY HEALTH CENTER
Authorized official JESSIE PETERSON - (COO)
Entity Organization
Organization subpart No
Enumeration date 12/04/2017
Last updated 02/08/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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