Organization
THE LAKES COMMUNITY HEALTH CENTER, INC
Active
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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