| NPI | 1891242111 |
|---|---|
| Doing Business As | NORTHLAKES COMMUNITY CLINIC |
| Entity Type | Organization |
| Authorized Contact | BRIAN AHLGREN CFO 715-934-3056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2021-07-30 |