Bear Lake Community Health Center, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · North Logan, UT
NPI 1063630705 · NPPES record last updated Jun 1, 2022
Key facts
- NPI
- 1063630705
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- BEAR LAKE COMMUNITY HEALTH CENTER, INC.
- Practice address
- 1515 N 400 E Ste 104
North Logan, UT 84341-7595 - Phone
- (435) 946-3660
- NPI assigned
- Apr 20, 2007
- Organization subpart
- No
Authorized official
- Name
- Jorge Garcia
- Title
- Ceo
- Phone
- (435) 755-6061
National Provider Directory
Locations
517 W 100 N
Ste 210
Providence, UT 84332
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
1515 N 400 E Ste 104
North Logan, UT 84341-7595
Mailing address
517 W 100 N Ste 210
Providence, UT 84332-9826
Phone (435) 946-3660
Other names
- CACHE VALLEY COMMUNITY HEALTH CENTER
Other providers in North Logan, UT
- John Charles Bailey
- Michelle C Bailey
- Sandra Ballard
- Deena Balls
- Jeffrey Call Baugh
- Jeffrey Green Bennion
- Caitlin Sayard Benvenuti
- Bradley Pope Bills
- James Wallentine Blotter
- Andrea Ellis Bott
All providers in North Logan, UT · Federally Qualified Health Center (FQHC) in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.