Organization
THE LAKES COMMUNITY HEALTH CENTER, INC
Active
Other names
NorthLakes Community Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN AHLGREN (CFO)
(715) 934-3056
Entity
Organization
Contact information
Practice address
320 SUPERIOR AVE STE D, WASHBURN, WI 54891-9428
(715) 373-2233
(715) 373-5530
Mailing address
15735 W US HIGHWAY 63, HAYWARD, WI 54843-6475
(715) 934-0710
(715) 598-4881
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811178825
—
WI
Enumeration date
09/02/2016
Last updated
07/30/2021
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