SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC


Address: 4022 Hohman Ave, Hammond, IN 46327
Phone: 2199373300

SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC (NPI# 1609231927) 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) 1609231927
Entity Type Organization
Organization Name SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC
Other Organization Name REGIONAL HEALTH CLINIC
Practice Address 4022 Hohman Ave
Hammond
IN 46327
Mailing Address 8400 Louisiana St
Merrillville
IN 46410-6385
Practice Telephone 2199373300
Practice Fax Number 2198037252
Mailing Telephone 2197571924
Mailing Fax Number 2197571950
Enumeration Date 2015-12-31
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 CLIA 15D2108285 01
IN 201323280 05

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
1376919217 Southlake Community Mental Health Center, Inc Clinic/Center 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 2015-08-14

Office Location

Street Address 4022 HOHMAN AVE
City HAMMOND
State IN
Zip Code 46327

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437180346 Rujuta R Gandhi Family Medicine 4022 Hohman Ave, Hammond, IN 46327-1239 2006-07-06
1942587449 Lori Ann Morrow Nurse Practitioner 4022 Hohman Ave, Hammond, IN 46327-1239 2011-11-10
1306067392 Sujittra Niyakorn Family Medicine 4022 Hohman Ave, Hammond, IN 46327-1239 2007-05-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952445330 William M. Bercik Dentist 3810 S Hohman Ave, Hammond, IN 46327-1159 2007-02-18
1295877694 Hoosier Pharmacy Pharmacy 3833 Hohman Ave., Hammond, IN 46327-1160 2007-02-13
1558440149 St Margaret Mercy Healthcare Centers Family Medicine 3831 S Hohman Ave, Hammond, IN 46327-1160 2006-11-03
1538151261 Claude E Foreit Family Medicine 3831 Hohman Ave, Hammond, IN 46327-1160 2005-08-18
1508858069 Claude A Foreit Family Medicine 3831 Hohman Ave, Hammond, IN 46327-1160 2005-08-19
1356333082 Christopher John Mcintire Family Medicine 3831 Hohman Ave, Hammond, IN 46327-1160 2005-08-18
1659923894 Genoa Healthcare, LLC Pharmacy 4022 Hohman Ave Ste 103, Hammond, IN 46327-1239 2019-07-09
1528285897 St. Joseph Home for Boys, Inc Residential Treatment Facility, Emotionally Disturbed Children 4007 S Sheffield Ave, Hammond, IN 46327-1242 2007-04-19
1215545363 Shenell Moore Spec/Tech, Pathology 225 Gostlin St, Hammond, IN 46327-1302 2020-07-15
1205346491 Leo Jovan Corral Specialist/Technologist 4434 Cameron Ave, Hammond, IN 46327-1359 2017-10-03
Find all providers in zip 46327

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
1023642576 Southlake Community Mental Health Center Inc. Clinic/Center 2250 173rd St Ste 111, Hammond, IN 46323-2074 2020-02-24
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
Find all providers in HAMMOND

Competitor

Search similar providers

City HAMMOND
Zip Code 46327

Improve Information

Please comment or provide details below to improve the information on SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC.

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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