Organization
LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC.
Active
Organization
LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERNESTO PADILLA (EXECUTIVE DIRECTOR)
(541) 263-8382
Entity
Organization
Contact information
Practice address
14678 LAKESHORE BOULEVARD, CLEARLAKE, CA 95453
(707) 262-8382
Mailing address
PO BOX 1950, LAKEPORT, CA 95453-1950
(707) 263-8382
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/18/2015
Last updated
04/02/2024
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