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 |
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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 |
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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 |
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Provider Enumeration Date | 07/15/2022 |
Last Update Date | 07/15/2022 |
Identifier | Type | State | Issuer |
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1184358004 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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