CITIZENS OF LAKE COUNTY FOR HEALTH CARE INC

NPI # 

Practice Address:

130 N Main St

Ridgely, TN, 38080-1317

Practice Phone:

731-264-5518

Practice Fax:

731-264-6859

License Number:

6899

License State:

TN

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Federally Qualified Health Center (FQHC)

Taxonomy Code:

261QF0400X