SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER (NPI# 1902043672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902043672 |
| Entity Type | Organization |
| Organization Name | SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER |
| Other Organization Name | REGIONAL MENTAL HEALTH CENTER |
| Practice Address |
8555 Taft St Merrillville IN 46410-6123 |
| Mailing Address |
8400 Louisiana St Merrillville IN 46410-6385 |
| Practice Telephone | 2197694005 |
| Mailing Telephone | 2197571928 |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2009-06-18 |
| Authorized Official Name | MR. ROBERT KRUMWIED (PRESIDENT/CEO) |
| Authorized Official Telephone | 2197571970 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100157670B | 05 |
| Other Name | Type Code |
|---|---|
| Regional Mental Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386107746 | Southlake Community Mental Health Center | Clinic/Center | 8555 Taft St, Merrillville, IN 46410-6123 | 2019-04-11 |
| 1811134588 | Southlake Community Mental Health Center | Non-emergency Medical Transport (VAN) | 8555 Taft St, Merrillville, IN 46410-6123 | 2009-01-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER INC | 8555 Taft Street, Merrillville, IN 46410 |
| Street Address |
8555 TAFT ST |
| City | MERRILLVILLE |
| State | IN |
| Zip Code | 46410-6123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114927142 | Jose Lorenzo Ramirez | Psychiatry & Neurology | 8555 Taft St, Merrillville, IN 46410 | 2005-08-01 |
| 1669098471 | Lucy Chavez-reyes | Registered Nurse | 8555 Taft St, Merrillville, IN 46410-6123 | 2020-06-18 |
| 1972126019 | Jennifer Vega | Registered Nurse | 8555 Taft St, Merrillville, IN 46410-6123 | 2020-05-23 |
| 1043832280 | Christine M Juda | Registered Nurse | 8555 Taft St, Merrillville, IN 46410-6123 | 2020-05-11 |
| 1881227650 | Deidre Blackwell | Counselor | 8555 Taft St, Merrillville, IN 46410-6123 | 2020-02-19 |
| 1316582018 | Ameer Elsalaymeh | Counselor | 8555 Taft St, Merrillville, IN 46410-6123 | 2019-11-18 |
| 1548816077 | Nora Alfonsi | Dietitian, Registered | 8555 Taft St, Merrillville, IN 46410-6123 | 2019-08-12 |
| 1932752573 | Eric B Jimenez | Counselor | 8555 Taft St, Merrillville, IN 46410-6123 | 2019-07-23 |
| 1265084859 | Shawn Smith | Nurse Practitioner | 8555 Taft St, Merrillville, IN 46410-6123 | 2019-07-12 |
| 1194382929 | Vincent Liszewski | Registered Nurse | 8555 Taft St, Merrillville, IN 46410-6123 | 2019-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023636867 | Lena Danielle Clouse | Pharmacist | Genoa Healthcare LLC, 8555 Taft Street, Merrillville, IN 46410 | 2020-07-08 |
| 1134752728 | All In One Therapy, LLC | Speech-Language Pathologist | 1800 W 84th Drive, Merrillville, IN 46410 | 2020-02-21 |
| 1134759335 | David John Kujawa | Social Worker | 8398 Mississippi St., Merrillville, IN 46410 | 2020-01-16 |
| 1619513603 | Activate Healthcare - Plumbers Local 210 Clinic | Clinic/Center | 2905 E 83rd Place, Merrillville, IN 46410 | 2019-11-25 |
| 1568946994 | Larry Smith | Case Manager/Care Coordinator | 233 E 83, Merrillville, IN 46410 | 2018-09-21 |
| 1114401536 | The Sheet People | Durable Medical Equipment & Medical Supplies | 8874 Louisiana Street, Merrillville, IN 46410 | 2018-09-21 |
| 1659858439 | Heather Grinder | Hearing Instrument Specialist | 9120 Connecticut Dr., Suite C, Merrillville, IN 46410 | 2018-07-24 |
| 1710463872 | Mitchell G Smith | Optometrist | 1601 E 81st Ave, Merrillville, IN 46410 | 2018-07-12 |
| 1336631753 | Nwi Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 1454 E. 86th Place, Merrillville, IN 46410 | 2018-06-01 |
| 1659860427 | Wendell B Fleming | Counselor | 230 West 175th Place, Apartment I, Merrillville, IN 46410 | 2018-05-07 |
| Find all providers in zip 46410 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174038418 | A New Beginning Community Center | Clinic/Center | 5490 Broadway Ste L-11, Merrillville, IN 46410-1663 | 2017-12-08 |
| 1366815615 | Psi Services of Indiana Inc. | Clinic/Center | 8120 Georgia St Ste D, Merrillville, IN 46410-6391 | 2015-11-09 |
| 1528337318 | National Youth Advocate Program | Clinic/Center | 1551 E 85th Ave, Merrillville, IN 46410-8901 | 2011-12-22 |
| 1801040530 | Carol B Edwards, Psyd, Hspp, Clinical Psychologist, LLC | Clinic/Center | 9111 Broadway, Suite N, Merrillville, IN 46410-8122 | 2008-11-07 |
| 1023169893 | Human Services, Inc | Clinic/Center | 6111 Harrison St, Merrillville, IN 46410-2969 | 2007-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093676 | Life Skills Unlimited LLC | Clinic/Center | 6433 E Washington St Ste 185, Indianapolis, IN 46219-6624 | 2020-11-06 |
| 1083214159 | Amber Kinney, LLC | Clinic/Center | 623 S Washington St Apt A, Bloomington, IN 47401-5645 | 2020-10-28 |
| 1710585997 | Bloomington Neurofeedback | Clinic/Center | 1905 S Liberty Dr, Bloomington, IN 47403-5146 | 2020-10-11 |
| 1255943346 | Reality Counseling LLC | Clinic/Center | 5610 Crawfordsville Rd Ste 605, Indianapolis, IN 46224-3715 | 2020-08-19 |
| 1326658568 | Jennifer Steinmetz Msw LLC | Clinic/Center | 115 N College Ave Ste 225, Bloomington, IN 47404-4099 | 2020-08-03 |
| 1376161810 | North Clark Behavioral Health LLC | Clinic/Center | 2100 Market St Ste 200, Charlestown, IN 47111-8507 | 2020-07-10 |
| 1265068084 | Wellness Etc LLC | Clinic/Center | 1133 W Mill Rd Ste 200, Evansville, IN 47710-3877 | 2020-03-13 |
| 1114553948 | Johnson Nichols Health Clinic, Inc. | Clinic/Center | 720 N Marr Rd Ste A, Columbus, IN 47201-6660 | 2020-03-12 |
| 1376174904 | Karen Brosius LLC | Clinic/Center | 901 S Rogers St Ste 201, Bloomington, IN 47403-4760 | 2020-02-02 |
| 1396385886 | Urban Act Academy | Clinic/Center | 1250 E Market St, Indianapolis, IN 46202-3831 | 2020-01-13 |
| Find all providers with the same taxonomy | ||||
| City | MERRILLVILLE |
| Zip Code | 46410 |
Please comment or provide details below to improve the information on SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER.
| 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.