institution
Lake County Tribal Health Consortium Inc.
Federally Qualified Health Center (FQHC) in Lakeport, California
NPI 1881697381

Lake County Tribal Health Consortium Inc. is a Federally Qualified Health Center (FQHC) based in Lakeport, CA and is specialized in Federally Qualified Health Center (FQHC). Lake County Tribal Health Consortium Inc. practices in Lakeport, CA. The NPI Number for Lake County Tribal Health Consortium Inc. is 1881697381 and holds a License No. 110000289 (California).

The current practice location address for Lake County Tribal Health Consortium Inc. is 925 Bevins Ct, Lakeport, CA and can be reached out via phone at 707-263-8382 and via fax at 707-263-0329.

Location: 925 Bevins Ct, Lakeport, CA, 95453-9754
institution
Provider Profile Details
NPI Number
1881697381
Provider Name
Lake County Tribal Health Consortium Inc.
Credential
Provider Entity Type
Organization
Address
925 Bevins Ct, Lakeport, CA, 95453-9754
Phone Number
707-263-8382
Fax Number
707-263-0329
Provider Enumeration Date
05/27/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
THP70611F 05 CA
institution
Provider Business Practice Location Address Details
Address
925 Bevins Ct
City
State
Zip
95453-9754
Phone Number
707-263-8382
Fax Number
707-263-0329
person
Provider Business Mailing Address Details
Address
925 Bevins Ct
City
State
Zip
95453-9754
Phone Number
707-263-8382
Fax Number
707-263-0329
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
110000289 (California)
Definition
Definition to come...
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