LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC. is a federally qualified health center (fqhc) clinic center in Clearlake, CA. LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC. NPI is 1285000810. The provider is registered as an organization entity type.
The provider's business location address is:
14678 LAKESHORE BOULEVARD
CLEARLAKE, CA
ZIP 95453
Phone: (707) 262-8382
The provider's authorized official is Ernesto Padilla .
The authorized official title is Executive Director and has the following contact phone number (541) 263-8382.
The CLIA number assigned to this NPI record is 05D0722889 - other - tribal/ihs joint venture with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 8/18/2015 and was last updated on 4/2/2024.