Organization
LAKE COUNTY TRIBAL HEALTH MIDDLETOWN CLINIC
Active
Parent organization
LAKE COUNTY TRIBAL HEALTH CONSORTIUM INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKE COUNTY TRIBAL HEALTH CONSORTIUM INC.
Authorized official
THOMAS BURNETT (EHR SPECIALIST)
(707) 263-8382
Entity
Organization
Contact information
Practice address
22223 CA-29, RANCHERIA ROAD, TRIBAL OFFICES #1035, MIDDLETOWN, CA 95461
(707) 263-8382
Mailing address
PO BOX 1950, LAKEPORT, CA 95453-1950
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
02/05/2025
Last updated
02/05/2025
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