SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER INC. (NPI# 1023642576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023642576 |
| Entity Type | Organization |
| Organization Name | SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER INC. |
| Other Organization Name | PNW CLINIC |
| Practice Address |
2250 173rd St Ste 111 Hammond IN 46323-2074 |
| Mailing Address |
8555 Taft St Merrillville IN 46410-6123 |
| Practice Telephone | 2197694005 |
| Mailing Telephone | 2197694005 |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2020-02-26 |
| Authorized Official Name | JUDITH SIKORA (CFO) |
| Authorized Official Telephone | 2197571921 |
| 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 |
|---|---|
| PNW CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972092047 | Southlake Community Mental Health Center Inc. | Clinic/Center | 3903 Indianapolis Blvd, East Chicago, IN 46312 | 2018-05-04 |
| 1548407216 | Southlake Community Mental Health Center Inc. | Psychiatric Hospital | 8555 Taft St, Merrillville, IN 46410-6123 | 2009-01-16 |
| 1821081290 | Southlake Community Mental Health Center Inc. | Clinic/Center | 8555 Taft St, Merrillville, IN 46410-6123 | 2005-08-31 |
| Street Address |
2250 173RD ST STE 111 |
| City | HAMMOND |
| State | IN |
| Zip Code | 46323-2074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477052645 | Orthospine Monitoring LLC | Psychiatry & Neurology | 2901 Carlson Drive, Suite 375, Hammond, IN 46323 | 2018-02-02 |
| 1790863256 | Pacific Healthcare, Inc. | Clinic/Center | 6829-1/2 S. Grand Avenue, Hammond, IN 46323 | 2006-11-01 |
| 1083061568 | Thomas Wilkins | Family Medicine | 3432 169th St, Hammond, IN 46323 | 2016-05-16 |
| 1891070678 | Andrea Clarice Nygaard | Pharmacist | 6905 Kennedy Ave, Hammond, IN 46323 | 2011-10-12 |
| 1053584938 | Waneta Deshon Willis-cooper | Developmental Therapist | 6116 Marshall Ave, Hammond, IN 46323-1054 | 2008-04-10 |
| 1255948204 | Independence Plus-in, LLC | Home Health | 2901 Carlson Dr Ste 361, Hammond, IN 46323-1100 | 2020-09-24 |
| 1174146799 | Inspire Nursing Services | Home Health | 2901 Carlson Dr Ste 371, Hammond, IN 46323-1100 | 2020-05-19 |
| 1134241805 | Gina Marie Maldonado | Developmental Therapist | 3232 165th St, Hammond, IN 46323-1213 | 2007-04-04 |
| 1871659599 | Joseph Robert Kolanko | Chiropractor | 3224 165th St, Hammond, IN 46323-1218 | 2006-12-28 |
| 1114211844 | Swts | Non-emergency Medical Transport (VAN) | 6411 Grand Ave, Hammond, IN 46323-1230 | 2011-05-27 |
| Find all providers in zip 46323 | ||||
| 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 |
|---|---|---|---|---|
| 1376062513 | Southeast Community Health Systems | Clinic/Center | 43052 Yokum Rd, Hammond, LA 70403-6351 | 2017-09-19 |
| 1194277806 | Southeast Community Health Systems | Clinic/Center | 501 Erwin Neil Way Hammond, Hammond, LA 70403 | 2016-10-28 |
| 1568810794 | Southeast Community Health Systems | Clinic/Center | 1500 Phoenix Sq, Hammond, LA 70403-3954 | 2016-05-27 |
| 1841647013 | Southeast Community Health Systems | Clinic/Center | 125 W Tornado Dr, Hammond, LA 70401-1334 | 2016-05-18 |
| 1790163715 | Access Health Louisiana | Clinic/Center | 42351 Phyllis Ann Dr, Hammond, LA 70403-1254 | 2015-05-11 |
| 1508297540 | Southlake Community Mental Health Center, Inc. | Clinic/Center | 527 State St, Hammond, IN 46320-1533 | 2013-12-02 |
| 1881946267 | Community Healthnet, Inc | Clinic/Center | 5927 Columbia Ave, Hammond, IN 46320-2611 | 2012-10-09 |
| 1366617367 | Southeast Community Health Systems | Clinic/Center | 30575 Old Baton Rouge Highway, Hammond, LA 70403 | 2008-04-30 |
| 1265080295 | Access Health Louisiana | Clinic/Center | 2545 Veterans Ave, Hammond, LA 70403-1513 | 2019-09-03 |
| 1700433596 | 219 Health Network Inc | Clinic/Center | 7217 Indianapolis Blvd, Hammond, IN 46324-2213 | 2019-08-26 |
| Find all providers in HAMMOND | ||||
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| 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.