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
600 W SHELL CREEK RD, MINONG, WI 54859-9302
(715) 466-2201
(715) 466-2205
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
26972
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811178825
—
WI
Enumeration date
08/08/2012
Last updated
08/05/2021
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