Colville Nation Community Health Centers
Clinic/Center, Federally Qualified Health Center (FQHC) in Inchelium, WA. Organization (NPI-2).
NPI number1679697155
StatusActive
Last updated in NPPESJun 16, 2018
Details
- NPI
- 1679697155
- Entity type
- Organization (NPI-2)
- Legal business name
- Colville Nation Community Health Centers
- Organization subpart
- No
- Enumeration date
- Mar 19, 2007
- Last updated
- Jun 16, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | Yes |
| 261Q00000X | Clinic/Center | – | – | |
| 261QD0000X | Clinic/Center, Dental | – | – | |
| 261QR1300X | Clinic/Center, Rural Health | – | – |
Other names
- Inchelium Clinic (Other Name)
- Confederated Tribes Of The Colville Reservation (Former Legal Business Name)
- Lake Roosevelt Community Health Centers (Doing Business As)
Practice location
39 Shortcut RoadInchelium, WA 99138-0290
Phone 509-722-7006 · Fax 509-722-7021
Mailing address
Po Box 290Inchelium, WA 99138-0290
Phone 509-722-7006 · Fax 509-722-7021
Authorized official
Sue Burkhart
Biller
5097227006
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