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General NPI Number Information
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NPI Number | 1568759249
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Entity Type | Organization
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Legal Business Name | LINCOLN COUNTY COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 07/01/2011
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 100 DEWEY AVE
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City | EUREKA
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State | MT
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Zip | 59917
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Country | US
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Telephone | 406-297-7220
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Fax | 406-297-7221
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Provider Business Mailing Address
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Address Line | 320 E 2ND ST
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City | LIBBY
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State | MT
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Zip | 59923-2010
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Country | US
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Telephone | 406-283-6900
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Fax | 406-293-6622
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARIA CLEMONS
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Credential |
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Telephone | 406-283-6919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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