OrganizationActive
Lake Superior Community Health Center
NPI 1063789022 · Federally Qualified Health Center (FQHC) · Superior, WI
Provider details
- NPI number
- 1063789022
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Lee Homan, Ceo(715) 392-1955
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2222 E 5th St
Superior, WI 54880-3709
Phone: (715) 392-1955
Fax: (715) 392-1935
Approximate (ZIP-level) locationGet directions
Mailing address
2222 E 5th St
Superior, WI 54880-3709
Registry dates
- Enumerated
- 2011-11-18
- Last updated
- 2024-02-13
- Certified
- 2024-02-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.