NPI | 1518690841 |
---|---|
Doing Business As | NORTHLAKES COMMUNITY CLINIC |
Entity Type | Organization |
Authorized Contact | REBECCA RICE CEO 715-372-0323 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2022-07-05 |
Last Update Date | 2023-10-12 |