LICE CLINICS OF AMERICA- NORTHWEST INDIANA (NPI# 1083103485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083103485 |
| Entity Type | Organization |
| Organization Name | LICE CLINICS OF AMERICA- NORTHWEST INDIANA |
| Practice Address |
1010 Breuckman Dr Crown Point IN 46307-7530 |
| Mailing Address |
18909 Parrish Ave Lowell IN 46356-9618 |
| Practice Telephone | 2197792289 |
| Mailing Telephone | 6306244544 |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2018-05-02 |
| Authorized Official Name | RANDAL KLACKLE (OWNER) |
| Authorized Official Telephone | 6306244544 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247200000X | Technician, Other | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1010 BREUCKMAN DR |
| City | CROWN POINT |
| State | IN |
| Zip Code | 46307-7530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972117935 | Alimat O Biokoro | Home Health Aide | 1446 W 94th Ct., Crown Point, IN 46307 | 2020-09-06 |
| 1508489931 | Gentle Hearts Cardiovascular Institution LLC | Internal Medicine | 5221 W Lincoln Hwy, Suite 1a, Crown Point, IN 46307 | 2020-05-20 |
| 1659933646 | Darshak Joshi | Physical Therapist | 860 Stillwater Parkway, Crown Point, IN 46307 | 2019-07-01 |
| 1215592001 | Jamie Monday | Counselor | 1416 East Joliet St., Crown Point, IN 46307 | 2019-05-07 |
| 1790281152 | Tempus Labs Inc. | Clinical Medical Laboratory | 9800 Connecticut Drive, Suite A2-100, Crown Point, IN 46307 | 2018-04-04 |
| 1669991170 | Katie Lynn Eich | Counselor | 1308 N. Main St, Crown Point, IN 46307 | 2017-09-15 |
| 1053847251 | Nicole Bashan Lewis | Counselor | 1325 W 98th Ave, Crown Point, IN 46307 | 2017-05-08 |
| 1710433008 | Paul Alvin Clavecilla | Physical Therapist | 1099 South Main St., Apt. 314, Crown Point, IN 46307 | 2016-08-28 |
| 1851761365 | Cynthia Catherine Grass Black | Social Worker | 8592 Bell Lane, Crown Point, IN 46307 | 2015-09-28 |
| 1326437799 | Ameya Dorsatwar | Physical Therapist | 1516 North Main St, Crown Point, IN 46307 | 2015-01-22 |
| Find all providers in zip 46307 | ||||
| Taxonomy Code | 247200000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Technician, Other |
| A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |
| Notes: Sources: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988; Dorland’s Illustrated Medical Dictionary, 26th Edition. Philadelphia: W.B. Saunders Company, 1981; and Webster’s II New Riverside University Dictionary. Boston: Riverside Publishing Company, 1984. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053864058 | Regina Reevesscaife | Technician, Other | 1611 S Vernon St, South Bend, IN 46613-3214 | 2016-07-27 |
| 1699127001 | Jaime Lynn Harvey | Technician, Other | 1653 Park Hurst Dr, Indianapolis, IN 46229-4130 | 2016-07-08 |
| 1447601265 | Dominique Simmons | Technician, Other | 5638 E 18th St, Indianapolis, IN 46218-5017 | 2016-06-22 |
| 1124474333 | Esther Kather | Technician, Other | 1216 Brook Run Dr, 3a, Mishawaka, IN 46544-9285 | 2016-05-05 |
| 1215393780 | Kirt Anthony Shepard | Technician, Other | 1106 S 20th St, Apt 321 A, South Bend, IN 46615-1668 | 2016-01-13 |
| 1467818104 | Monica Fryska | Technician, Other | 15121 Clifden Dr, Granger, IN 46530-8205 | 2016-01-11 |
| 1639551344 | Sara Allyn Shrivastav | Technician, Other | 3711 E Southport Rd, Indianapolis, IN 46227 | 2015-06-18 |
| 1619364312 | Latoya Janae Swanson | Technician, Other | 52718 E Cypress Cir, South Bend, IN 46637-4607 | 2015-04-20 |
| 1528454766 | Angelika Colpitts | Technician, Other | 7202 E 350 N, Rolling Prairie, IN 46371-9438 | 2015-04-14 |
| 1871991075 | Sarah Trueb | Technician, Other | 30 Professional Ct Ste 3, Lafayette, IN 47905-5129 | 2014-12-21 |
| Find all providers with the same taxonomy | ||||
| City | CROWN POINT |
| Zip Code | 46307 |
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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.