Organization
BEAR LAKE COMMUNITY HEALTH CENTER, INC.
Active
Other names
CACHE VALLEY COMMUNITY HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE GARCIA (CEO)
(435) 755-6061
Entity
Organization
Contact information
Practice address
1515 N 400 E STE 104, NORTH LOGAN, UT 84341-7595
(435) 946-3660
Mailing address
517 W 100 N STE 210, PROVIDENCE, UT 84332-9826
(435) 946-3660
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
04/20/2007
Last updated
06/01/2022
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