Organization Name: | LEWIS COUNTY COMMUNITY HEALTH SERVICES |
NPI Number: | 1205196540 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN CLARK (EXECUTIVE DIRECTOR) |
Mailing Address: | 300 Ocean Ave Raymond |
State: | WA US |
Postal Code: | 985773016 |
Phone Number: | 3609423040 |
Fax Number: | 3609423955 |
NPI Enumeration Date: | 05/21/2012 |
NPI Last Update Date: | 03/31/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |