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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