| Organization Name: | THE LAKES COMMUNITY HEALTH CENTER, INC |
| NPI Number: | 1518306893 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JASON AKL (COO) |
| Mailing Address: | 600 W Shell Creek Rd Minong |
| State: | WI US |
| Postal Code: | 548599302 |
| Phone Number: | 7154662201 |
| Fax Number: | 7154662205 |
| NPI Enumeration Date: | 06/19/2013 |
| NPI Last Update Date: | 06/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0002X |
| License Number: | 9206-42 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Clinic Pharmacy |
| Taxonomy Definition: | A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |