OrganizationActive
Lakeshore Community Health Care, Inc
NPI 1184358004 · Federally Qualified Health Center (FQHC) · West Bend, WI
Provider details
- NPI number
- 1184358004
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Caleb Jensema, Cfo(920) 783-6633
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
908 W Washington St
West Bend, WI 53095-2430
Phone: (920) 783-6633
Street-level locationGet directions
Mailing address
Po Box 959
Sheboygan, WI 53082-0959
Registry dates
- Enumerated
- 2022-07-15
- Last updated
- 2022-07-15
- Certified
- 2022-07-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.