| Organization Name: | LAKE HEALTH DISTRICT |
| NPI Number: | 1376698522 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GORDON ENSLEY (CEO) |
| Mailing Address: | 700 S J St Lakeview |
| State: | OR US |
| Postal Code: | 976301623 |
| Phone Number: | 5419472114 |
| Fax Number: | 5419472433 |
| NPI Enumeration Date: | 01/25/2007 |
| NPI Last Update Date: | 07/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC0050X |
| License Number: | 140896 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Critical Access Hospital |
| Taxonomy Definition: | An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified. |