Organization
CITIZENS OF LAKE COUNTY FOR HEALTH CARE INC
Active
Other names
Lake County Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMBER MARIE ISBELL (FINANCIAL OFFICER)
(731) 253-6690
Entity
Organization
Contact information
Practice address
710 CARL PERKINS PKWY, TIPTONVILLE, TN 38079
(731) 253-6690
(731) 253-6692
Mailing address
710 CARL PERKINS PKWY, TIPTONVILLE, TN 38079
(731) 253-6690
(731) 253-6692
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992848816
NPI DR. CAROL GUESS
—
05
—
444-7958
—
TN
Enumeration date
04/02/2007
Last updated
11/06/2012
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