Organization
LAKELAND IMMEDIATE CARE CENTER
Active
Parent organization
LAKELAND IMMEDIATE CARE CENTER
Other names
Niles Community Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKELAND IMMEDIATE CARE CENTER
Authorized official
JOSEPH GAVAN (EXECUTIVE DIRECTOR)
(269) 445-3874
Entity
Organization
Contact information
Practice address
1951 OAK ST, NILES, MI 49120-3738
(269) 262-4749
(269) 262-4739
Mailing address
1951 OAK ST, NILES, MI 49120-3738
(269) 262-4749
(269) 262-4739
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MI
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Enumeration date
04/25/2014
Last updated
09/04/2025
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