| Northlakes Community Clinic | |
|
110 2nd Ave N Park Falls WI 54552-1214 | |
| (715) 762-2950 | |
| (715) 762-3561 |
| Full Name | Northlakes Community Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 110 2nd Ave N, Park Falls, Wisconsin |
| Authorized Official Name and Position | Rebecca Rice (CEO) |
| Authorized Official Contact | 7153725001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northlakes Community Clinic 15735 W Us Highway 63 Hayward WI 54843-6475 Ph: (715) 934-0710 | Northlakes Community Clinic 110 2nd Ave N Park Falls WI 54552-1214 Ph: (715) 762-2950 |
| NPI Number | 1437619202 |
|---|---|
| Provider Enumeration Date | 03/20/2019 |
| Last Update Date | 10/12/2023 |
| Medicare PECOS PAC ID | 0840366654 |
|---|---|
| Medicare Enrollment ID | O20231012000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437619202 | NPI | - | NPPES |
| 1811178825 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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