OrganizationActive
Bear Lake Community Health Center, Inc.
NPI 1235495771 · Federally Qualified Health Center (FQHC) · Evanston, WY
Provider details
- NPI number
- 1235495771
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jorge Garcia, Ceo(435) 755-6061
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
75 Yellow Creek Rd
Suite 102
Evanston, WY 82930-5235
Phone: (307) 789-8290
Fax: (307) 789-8975
Approximate (ZIP-level) locationGet directions
Mailing address
517 W 100 N Ste 210
Providence, UT 84332-9826
Other names (DBA / former)
- Doing business as
- Evanston Community Health Center
- Doing business as
- Evanston Community Health Center
Registry dates
- Enumerated
- 2012-04-10
- Last updated
- 2022-06-01
- Certified
- 2022-06-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.