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CHC08784-05 LAKES COMMUNITY HEALTH CENTER, INC., THE (Terminated)
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Main Details
Name
LAKES COMMUNITY HEALTH CENTER, INC., THE
Subdivision Name
NorthLakes - Turtle Lake
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014863
340B ID
CHC08784-05
Grant Number
H80CS08784
Additional Details
Current Program Status
Terminated
Registration Date
7/7/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/10/2015
Last Recertification Date
2/8/2018
Termination Date
Termination Reason
4/1/2019
Other
Contacts
Authorizing Official
NorthLakes Community Clinic
Jason Akl, COO
(715) 372-5001 Ext: 1211
Primary Contact
The Lakes Community Health Center
Christine Dryer, Pharmacy Director
(715) 372-5011
Addresses
Street Address
212 Maple Street South
Turtle Lake, WI 54889
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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