| Lakeshore Community Health Care, Inc | |
|
908 W Washington St West Bend WI 53095-2430 | |
| (920) 783-6633 | |
| Not Available |
| Full Name | Lakeshore Community Health Care, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 908 W Washington St, West Bend, Wisconsin |
| Authorized Official Name and Position | Caleb Jensema (CFO) |
| Authorized Official Contact | 9207836633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeshore Community Health Care, Inc Po Box 959 Sheboygan WI 53082-0959 Ph: () - | Lakeshore Community Health Care, Inc 908 W Washington St West Bend WI 53095-2430 Ph: (920) 783-6633 |
| NPI Number | 1184358004 |
|---|---|
| Provider Enumeration Date | 07/15/2022 |
| Last Update Date | 07/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184358004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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