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Contact Information

EDGEWATER SYSTERMS FOR BALANCED LIVING
1106 WEST 6 TH AVENUE
GARY, IN46402
 Phone: 219-885-4264
 Fax: 219-885-1332
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for EDGEWATER SYSTERMS FOR BALANCED LIVING

NPI Number 1790154417
LBN Legal business name EDGEWATER SYSTERMS FOR BALANCED LIVING
Authorized official THOMAS BUCKNER - (THERAPIST II)
Entity Organization
Organization subpart 1 No
Enumeration date 09/23/2015
Last updated 09/23/2015 - About 11 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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