SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC


Address: 3903 Indianapolis Blvd, East Chicago, IN 46312-2555
Phone: 2193987050

SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC (NPI# 1376919217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376919217
Entity Type Organization
Organization Name SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC
Other Organization Name REGIONAL HEALTH CLINIC
Practice Address 3903 Indianapolis Blvd
East Chicago
IN 46312-2555
Mailing Address 8400 Louisiana St
Merrillville
IN 46410-6385
Practice Telephone 2193987050
Practice Fax Number 2193926998
Mailing Telephone 2197571924
Mailing Fax Number 2197571950
Enumeration Date 2015-08-14
Last Update Date 2016-07-01
Authorized Official Name ROBERT KRUMWIED (CEO)
Authorized Official Telephone 2197367183
Is Organization Subpart N

Taxonomy

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 Provider Identifier

State Issuer Identifier Type Code
IN 201323280A 05
IN CLIA 15D2100511 01

Other Provider/Organization Names

Other Name Type Code
Regional Health Clinic Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1669973855 Southlake Community Mental Health Center, Inc Community/Behavioral Health 107 W 79th Ave, Merrillville, IN 46410-5438 2018-02-23
1366942518 Southlake Community Mental Health Center, Inc Clinic/Center 8555 Taft St, Merrillville, IN 46410-6123 2018-02-14
1609231927 Southlake Community Mental Health Center, Inc Clinic/Center 4022 Hohman Ave, Hammond, IN 46327 2015-12-31

Office Location

Street Address 3903 INDIANAPOLIS BLVD
City EAST CHICAGO
State IN
Zip Code 46312-2555

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801888037 Samina Niaz Khattak Psychiatry & Neurology 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 2005-08-15
1891333803 Kathleen Weir Psychiatry & Neurology 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 2019-12-20
1508340936 Sefelisha Harmon Nurse Practitioner 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 2018-09-21
1972092047 Southlake Community Mental Health Center Inc. Clinic/Center 3903 Indianapolis Blvd, East Chicago, IN 46312 2018-05-04
1215440060 Rondi Wightman Social Worker 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 2017-11-14
1215449491 Rochelle Grieger Pharmacist 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 2017-10-28
1962860775 Emily Brown Psychologist 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 2016-02-08
1699114033 Laura Uzelac Counselor 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 2013-06-19
1952651408 Valerie Perez Psychologist 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 2012-09-12
1548536196 Lolita O Ang Psychiatry & Neurology 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 2012-03-28
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1578025896 219 Health Network Inc Clinic/Center 4320 First Street, Suite 211, East Chicago, IN 46312 2019-04-04
1932663051 Melissa Lynn Del Rosario Registered Nurse St. Catherine Hospital, 4321 Fir St, East Chicago, IN 46312 2019-01-23
1851896013 Scot Eric West Registered Nurse 4320 Fir St Unit 217, East Chicago, IN 46312 2018-03-28
1528598380 Wellnes for Life Clinic/Center 1401 144th St, East Chicago, IN 46312 2017-06-14
1992116305 Familia Dental Ec LLC Dentist 4624a Magoun Avenue, East Chicago, IN 46312 2014-05-20
1821415076 Ericka Rouse Counselor 901 West Chicago Ave., East Chicago, IN 46312 2014-03-26
1568806057 St. Catherine Hospital Inc. Pharmacy 4321 Fir St., East Chicago, IN 46312 2013-04-26
1275882185 Planned Parenthood of Indiana East Chicago Clinic/Center 3931 Main Street, East Chicago, IN 46312 2012-09-06
1851417356 Deborah Ann Duda Nurse Practitioner 1155 E Alexis, Toledo, OH 46312 2007-03-22
1255457826 Major Hospital Skilled Nursing Facility 5025 Mccook Ave, East Chicago, IN 46312 2007-03-22
Find all providers in zip 46312

Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053944058 219 Health Network Inc Clinic/Center 1802 E Columbus Dr, East Chicago, IN 46312-2826 2020-02-18
1225661234 219 Health Network Inc Clinic/Center 4320 Fir St Unit 208, East Chicago, IN 46312-8410 2020-02-18
1578025896 219 Health Network Inc Clinic/Center 4320 First Street, Suite 211, East Chicago, IN 46312 2019-04-04
1578105490 219 Health Network Inc Clinic/Center 2001 E Columbus Dr, East Chicago, IN 46312-4109 2019-10-11
1366083776 219 Health Network Inc Clinic/Center 2020 E Columbus Dr Ste A, East Chicago, IN 46312-2830 2019-10-07
1285298067 Chikare Health System PC Clinic/Center 915 W Chicago Ave, East Chicago, IN 46312-3308 2019-04-26
1770045098 219 Health Network Inc Clinic/Center 525 W Chicago Ave, East Chicago, IN 46312-3206 2019-04-04
1265994636 219 Health Network Inc Clinic/Center 100 W Chicago Ave Ste F, East Chicago, IN 46312-3261 2019-04-03
1184069569 Healthlinc, Inc. Clinic/Center 1313 W Chicago Ave, East Chicago, IN 46312 2013-04-30
1639453871 East Chicago Community Health Center Clinic/Center 3903 Indianapolis Blvd, East Chicago Community Health Center At Regional, East Chicago, IN 46312-0000 2011-10-06
Find all providers in EAST CHICAGO

Competitor

Search similar providers

City EAST CHICAGO
Zip Code 46312

Improve Information

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Dataset Information

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.

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