Organization · Type 2 NPI
Citizens of Lake County for Health Care Inc
Federally Qualified Health Center (FQHC) · Ridgely, TN
NPI number
1851697817
Active
Practice location
130 N Main St
Ridgely, TN 38080-1317
Fax (731) 264-6859
Mailing address
130 North Main Street
Ridgely, TN 38080-1317
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | 6899 (TN) |
Federally Qualified Health Center (FQHC): Definition to come...
Another provider at this address
About NPI 1851697817
Citizens of Lake County for Health Care Inc's National Provider Identifier is 1851697817, issued on Feb 8, 2011. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Ridgely, TN. The record was last updated on Feb 8, 2011.