NORTHLAKES COMMUNITY CLINIC – NPI #1750878542
Clinic/Center

NORTHLAKES COMMUNITY CLINIC is an AHC clinic located in BIRCHWOOD, WI. NPPES has assigned the NPI number 1750878542 to NORTHLAKES COMMUNITY CLINIC on April 17, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “NORTHLAKES COMMUNITY CLINIC” is a dba name, the actual legal business name for this organization is THE LAKES COMMUNITY HEALTH CENTER, INC. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 7 years ago on Feb 05, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NORTHLAKES COMMUNITY CLINIC below.

NPI Profile for
THE LAKES COMMUNITY HEALTH CENTER, INC

NPI Number
1750878542
Enumeration Date

(more than 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
THE LAKES COMMUNITY HEALTH CENTER, INC
Doing Business As (dba): NORTHLAKES COMMUNITY CLINIC
Primary location
108 S MAIN ST
BIRCHWOOD, WI 54817
Phone: (715) 354-3369 Fax: (715) 354-7158
Mailing address
15954 RIVERS EDGE DR STE 304
HAYWARD, WI 54843-7894
Phone: (715) 634-2541 Fax: (715) 598-4881
Organization Subpart
No
Authorized Official
REBA RICE
CEO
Phone: (715) 372-5001
Updated
Identifiers

Identifiers for NORTHLAKES COMMUNITY CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDWI1811178825
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.