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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 Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

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

NPI Profile & details for LAKE SUPERIOR COMMUNITY HEALTH CENTER

NPI Number 1639684384
LBN Legal business name LAKE SUPERIOR COMMUNITY HEALTH CENTER
Authorized official JESSIE PETERSON - (COO)
Entity Organization
Organization subpart 1 No
Enumeration date 12/04/2017
Last updated 02/08/2021 - About 5 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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