BEAR LAKE COMMUNITY HEALTH CENTERS (NPI# 1417305087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417305087 |
Entity Type | Organization |
Organization Name | BEAR LAKE COMMUNITY HEALTH CENTERS |
Other Organization Name | CACHE VALLEY COMMUNITY HEALTH CENTER-LOGAN |
Practice Address |
944 S State Highway 89 Logan UT 84321-5436 |
Mailing Address |
517 W 100 N Ste 210 Providence UT 84332-9826 |
Practice Telephone | 4357556075 |
Practice Fax Number | 4357556091 |
Mailing Telephone | 4357556061 |
Mailing Fax Number | 4357556091 |
Enumeration Date | 2016-05-24 |
Last Update Date | 2018-09-21 |
Authorized Official Name | LAVAL B. JENSEN (CEO) |
Authorized Official Telephone | 4357556061 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Cache Valley Community Health Center-Logan | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235495771 | Bear Lake Community Health Centers | Clinic/Center | 75 Yellow Creek Rd, Suite 102, Evanston, WY 82930-5235 | 2012-04-10 |
1649546938 | Bear Lake Community Health Centers | Clinic/Center | 517 W 100 N Ste 110, Providence, UT 84332-9826 | 2012-03-30 |
Street Address |
944 S STATE HIGHWAY 89 |
City | LOGAN |
State | UT |
Zip Code | 84321-5436 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265074157 | Grant E Severe | Pharmacist | 175 E 442 N, Logan, UT 84321 | 2019-10-11 |
1437712585 | Gregory Scott Hansen | Pharmacist | 412 East 200 North, Logan, UT 84321 | 2019-04-15 |
1043701584 | Mckell Peidl | Behavior Technician | 240 E 400 N Apt 8, Logan, UT 84321 | 2018-05-21 |
1801331194 | Eric Dutson | Speech-Language Pathologist | 964 W 2880 S, Nibley, UT 84321 | 2016-12-22 |
1063805299 | Krystal Cox | Marriage & Family Therapist | 493 North 700 East, Logan, UT 84321 | 2015-03-12 |
1013340801 | Carly D. L. Lebaron | Marriage & Family Therapist | 95 W. 100 S., Suite 360, Logan, UT 84321 | 2013-08-15 |
1669710471 | Brandon Bailey | Counselor | 1465 N. 300 W., Ste. A, Brigham, UT 84321 | 2013-01-29 |
1871843086 | Brandi Lee Richins | Social Worker | 90 E. 200 N., Logan, UT 84321 | 2012-09-14 |
1922356732 | Stacy Lynn Hamilton Jones | Marriage & Family Therapist | 60 East Center Street, Suite 205, Keystone Family Solutions, Logan, UT 84321 | 2012-08-28 |
1992002455 | Robert Thomas Allred | Chiropractor | 944 South Highway 89/91, Logan, UT 84321 | 2011-02-18 |
Find all providers in zip 84321 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023331220 | Lincoln County Primary Care Center, Inc | Clinic/Center | 122 Nick Savas Drive, Logan, WV 25601-3468 | 2010-03-03 |
1336106632 | Community Health Foundation of Logan | Clinic/Center | Hc68 Box 1000, Suite 3, Logan, WV 25601-9620 | 2006-04-28 |
1669463360 | Hopewell Health Centers Inc | Clinic/Center | 30381 Chieftain Drive, Logan, OH 43138-1013 | 2005-11-02 |
1598396202 | Logan-mingo Area Mental Health, Inc | Clinic/Center | 174 Lmah Center Rd, Logan, WV 25601-4058 | 2020-01-31 |
1083169163 | Hopewell Health Centers Inc | Clinic/Center | 541 State Route 664 N Ste C, Logan, OH 43138-8541 | 2016-08-18 |
1366723975 | Lincoln County Primary Care Center, Inc. | Clinic/Center | 1 Wildcat Way, Logan, WV 25601-3474 | 2011-09-09 |
1063630705 | Bear Lake Community Health Center | Clinic/Center | 550 E 1400 N Ste K, Logan, UT 84341-2450 | 2007-04-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871014092 | Wayne Community Health Centers, Inc | Clinic/Center | 65 North Center Street, Escalante, UT 84776-0276 | 2017-06-28 |
1780090944 | Southwest Utah Community Health Center, Inc. | Clinic/Center | 391 North 200 West, Hurricane, UT 84737-1616 | 2014-07-09 |
1548588247 | Southwest Utah Community Health Center, Inc | Clinic/Center | 74 W. Harding Ave, Cedar City, UT 84720 | 2010-05-06 |
1528128899 | Wasatch Homeless Health Care, Inc. | Clinic/Center | 409 W 400 S, Salt Lake City, UT 84101-1135 | 2006-12-09 |
1689754475 | Bear Lake Community Health Center | Clinic/Center | 325 W. Logan Hwy, Garden City, UT 84028-0328 | 2006-10-16 |
1942317722 | Green River Medical Center Inc | Clinic/Center | 585 West Main St., Box 417, Green River, UT 84525-0417 | 2006-08-25 |
1659358687 | Southwest Utah Community Health Center | Clinic/Center | 25 N 100 E, Suite 102, St George, UT 84770 | 2005-12-30 |
1366447112 | Community Health Centers Inc. | Clinic/Center | 1365 W 1000 N, Slc, UT 84116-1654 | 2005-06-17 |
1477558237 | Community Health Centers Inc. | Clinic/Center | 8446 Harrison St, Midvale, UT 84047-3568 | 2005-06-17 |
1144834771 | Carbon Medical Service Assocation, Incorporated | Clinic/Center | 305 Center St, East Carbon, UT 84520-7726 | 2020-09-01 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on BEAR LAKE COMMUNITY HEALTH CENTERS.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.