LAKE SUPERIOR COMMUNITY HEALTH CENTER NPI 1699708297

NPI Information

NPI: 1699708297
Provider Name: LAKE SUPERIOR COMMUNITY HEALTH CENTER
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
4325 GRAND AVE
DULUTH, MN
ZIP 55807
Phone: (218) 722-1497
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LAKE SUPERIOR COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Duluth, MN. LAKE SUPERIOR COMMUNITY HEALTH CENTER NPI is 1699708297. The provider is registered as an organization entity type.

The provider's business location address is:

4325 GRAND AVE
DULUTH, MN
ZIP 55807-730
Phone: (218) 722-1497
Fax: (218) 722-6239

The provider's authorized official is Jessie Peterson .
The authorized official title is Ceo and has the following contact phone number (715) 395-1955.

The enumeration date for this NPI number is 7/8/2006 and was last updated on 2/3/2022.

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: 11/14/2023

NPI Synchronization or Removal

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