institution
Southlake Community Mental Health Center, Inc
Federally Qualified Health Center (FQHC) in East Chicago, Indiana
NPI 1376919217

Southlake Community Mental Health Center, Inc is a Federally Qualified Health Center (FQHC) based in Merrillville, IN and is specialized in Federally Qualified Health Center (FQHC). Southlake Community Mental Health Center, Inc practices in East Chicago, IN. The NPI Number for Southlake Community Mental Health Center, Inc is 1376919217 and holds a License No. (Indiana).

The current practice location address for Southlake Community Mental Health Center, Inc is 3903 Indianapolis Blvd, East Chicago, IN and can be reached out via phone at 219-398-7050 and via fax at 219-392-6998.

Location: 3903 Indianapolis Blvd, East Chicago, IN, 46410-6385
institution
Provider Profile Details
NPI Number
1376919217
Provider Name
Southlake Community Mental Health Center, Inc
Credential
Provider Entity Type
Organization
Address
3903 Indianapolis Blvd, East Chicago, IN, 46410-6385
Phone Number
219-398-7050
Fax Number
219-392-6998
Provider Enumeration Date
08/14/2015
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
201323280A 05 IN
15D2100511 01 IN CLIA
institution
Provider Business Practice Location Address Details
Address
3903 Indianapolis Blvd
City
State
Zip
46312-2555
Phone Number
219-398-7050
Fax Number
219-392-6998
person
Provider Business Mailing Address Details
Address
3903 Indianapolis Blvd
City
State
Zip
46312-2555
Phone Number
219-398-7050
Fax Number
219-392-6998
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
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Definition
Definition to come...
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