Organization
THE LAKES COMMUNITY HEALTH CENTER, INC
Active
Other names
NorthLakes Community Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
REBA RICE (CEO)
(715) 372-5001
Entity
Organization
Contact information
Practice address
820 ARBUTUS AVE, OCONTO, WI 54153-2004
(920) 516-7107
(920) 835-2919
Mailing address
15735 W US HIGHWAY 63, HAYWARD, WI 54843-6475
(715) 934-0710
(715) 598-4881
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
4757-800
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811178825
—
WI
Enumeration date
04/08/2013
Last updated
08/05/2021
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