Organization · Type 2 NPI

Bear Lake Community Health Center, Inc.

Federally Qualified Health Center (FQHC) · North Logan, UT

NPI number 1063630705 Active

Practice location

1515 N 400 E Ste 104
North Logan, UT 84341-7595

Call (435) 946-3660 Map

Mailing address

517 W 100 N Ste 210
Providence, UT 84332-9826

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

10 other providers at this address

Other federally qualified health center (fqhc) providers in North Logan

Health West, Inc.Federally Qualified Health Center (FQHC) North Logan, UT NPI 1457067381

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NPI record

NPI: 1063630705
Entity type: Organization (Type 2)
Issued: Apr 20, 2007
Last updated: Jun 1, 2022
Status: Active

Other names

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Cache Valley Community Health Center · doing business as
Cache Valley Community Health Center · doing business as

Authorized official

Jorge Garcia
CEO
(435) 755-6061

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1063630705

Bear Lake Community Health Center, Inc.'s National Provider Identifier is 1063630705, issued on Apr 20, 2007. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in North Logan, UT. The record was last updated on Jun 1, 2022.