| Lake Preston Clinic | |
|
709 4th St Se Lake Preston SD 57249-2116 | |
| (605) 847-4484 | |
| Not Available |
| Full Name | Lake Preston Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 709 4th St Se, Lake Preston, South Dakota |
| Authorized Official Name and Position | John Mengenhausen (CEO) |
| Authorized Official Contact | 6057724525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Preston Clinic 709 4th St Se Lake Preston SD 57249-2116 Ph: (605) 847-4484 | Lake Preston Clinic 709 4th St Se Lake Preston SD 57249-2116 Ph: (605) 847-4484 |
| NPI Number | 1629181904 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 06/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629181904 | NPI | - | NPPES |
| 5350030 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |