| NPI | 1891452314 |
|---|---|
| Doing Business As | NORTHLAKES COMMUNITY CLINIC |
| Entity Type | Organization |
| Authorized Contact | REBA RICE CEO 715-372-5001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2022-09-12 |