institution
Lake Superior Community Health Center
Federally Qualified Health Center (FQHC) in Superior, Wisconsin
NPI 1578781639

Lake Superior Community Health Center is a Federally Qualified Health Center (FQHC) based in Superior, WI and is specialized in Federally Qualified Health Center (FQHC). Lake Superior Community Health Center practices in Superior, WI. The NPI Number for Lake Superior Community Health Center is 1578781639 and holds a License No. (Wisconsin).

The current practice location address for Lake Superior Community Health Center is 3600 Tower Avenue, Superior, WI and can be reached out via phone at 715-392-1955 and via fax at 715-392-1935.

Location: 3600 Tower Avenue, Superior, WI, 54880-4477
institution
Provider Profile Details
NPI Number
1578781639
Provider Name
Lake Superior Community Health Center
Credential
Provider Entity Type
Organization
Address
3600 Tower Avenue, Superior, WI, 54880-4477
Phone Number
715-392-1955
Fax Number
715-392-1935
Provider Enumeration Date
04/23/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
32957500 05 WI
654448700 05 MN
institution
Provider Business Practice Location Address Details
Address
3600 Tower Avenue
City
State
Zip
54880-5337
Phone Number
715-392-1955
Fax Number
715-392-1935
person
Provider Business Mailing Address Details
Address
3600 Tower Avenue
City
State
Zip
54880-5337
Phone Number
715-392-1955
Fax Number
715-392-1935
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
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Definition
Definition to come...
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