Organization
BEAR LAKE COMMUNITY HEALTH CENTER, INC.
Active
Other names
Cache Valley Community Health Center - Providence
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE GARCIA (CEO)
(435) 755-6061
Entity
Organization
Contact information
Practice address
517 W 100 N STE 110, PROVIDENCE, UT 84332-9826
(435) 755-6075
(435) 994-8362
Mailing address
517 W 100 N STE 210, PROVIDENCE, UT 84332-9826
(435) 755-6061
(435) 994-8362
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
03/30/2012
Last updated
06/06/2022
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