LAKESHORE COMMUNITY HEALTH CARE INC. NPI 1659959450

NPI Information

NPI: 1659959450
Provider Name: LAKESHORE COMMUNITY HEALTH CARE, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 52D2293347

Address:
819 KENTUCKY AVE
SHEBOYGAN, WI
ZIP 53081
Phone: (920) 783-6633
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LAKESHORE COMMUNITY HEALTH CARE, INC. is a federally qualified health center (fqhc) clinic center in Sheboygan, WI. LAKESHORE COMMUNITY HEALTH CARE, INC. NPI is 1659959450. The provider is registered as an organization entity type.

The provider's business location address is:

819 KENTUCKY AVE
SHEBOYGAN, WI
ZIP 53081-954
Phone: (920) 783-6633
Fax: (920) 783-6392

The provider's authorized official is Martin Schaller .
The authorized official title is Cfo and has the following contact phone number (920) 783-6808.

The CLIA number assigned to this NPI record is 52D2293347 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/1/2021 and was last updated on 4/1/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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