Organization
THE LAKES COMMUNITY HEALTH CENTER, INC
Active
Other names
The Lakes Community Health Center, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
REBA RICE (CEO)
(715) 372-5001
Entity
Organization
Contact information
Practice address
15397 STATE HIGHWAY 32, LAKEWOOD, WI 54138-9702
(715) 276-6321
(715) 276-1428
Mailing address
PO BOX 179, LAKEWOOD, WI 54138-0179
(715) 276-6321
(715) 276-1428
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
—
3295500
—
WI
Enumeration date
05/27/2005
Last updated
03/19/2019
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