| NPI | 1639684384 |
|---|---|
| Doing Business As | LAKE SUPERIOR COMMUNITY HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | JESSIE PETERSON COO 218-722-1497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2021-02-08 |