# LEWIS CLARK STATE COLLEGE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LCSC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649366477
- **Authorized official:** DR. DENE KAY THOMAS PHD (PRESIDENT)
- **Authorized official phone:** (208) 792-2216

## Contact information

- **Practice address:** 500 8TH AVE, SGC \#42, LEWISTON, ID 83501-2691
- **Practice address phone:** (208) 792-2251
- **Practice address fax:** (208) 792-2882
- **Mailing address:** 500 8TH AVE, ADM 207, LEWISTON, ID 83501-2691
- **Mailing address phone:** (208) 792-2216
- **Mailing address fax:** (208) 792-2822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | M6537 | ID | Yes |

## Other

- **Enumeration date:** 10/05/2006
- **Last updated:** 08/22/2020