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Organization
BEAR LAKE COMMUNITY HEALTH CENTER, INC.
Active
Organization
BEAR LAKE COMMUNITY HEALTH CENTER, INC.
Active
Other names
Cache Valley Community Health Center, Cache Valley Community Health Center- Providence, Rock Springs Community Health Center, Bear Lake Community Health Center- Montpelier, Bear Lake Community Health Center, Box Elder Community Health Center, Bear Lake Community Health Center- Randolph, Evanston Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE GARCIA (CEO)
(435) 755-6061
Entity
Organization
Contact information
Practice address
325 WEST LOGAN HIGHWAY, GARDEN CITY, UT 84028-8001
(435) 946-3660
(435) 946-8215
Mailing address
517 W 100 N STE 210, PROVIDENCE, UT 84332-9826
(435) 755-6061
(435) 994-8362
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
122300000X
Dentist
—
NULL
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
NULL
1223G0001X
General Practice Dentistry
—
—
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
1835P1300X
Psychiatric Pharmacist
—
NULL
1835P1300X
Psychiatric Pharmacist
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
01/28/2010
Last updated
06/06/2022
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