| NPI | 1316797624 |
|---|---|
| Doing Business As | NORTHLAKES COMMUNITY CLINIC |
| Entity Type | Organization |
| Authorized Contact | ANA TOCHTERMAN CEO 888-834-4551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2025-06-10 |