SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER; NPI #1386107746

Contact Information

SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER

8555 TAFT ST
MERRILLVILLE, IN 46410-6123

Phone: 219-769-4005
Fax: 219-757-1950
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	261QR0401X	B4[14]	Comprehensive Outpatient Rehabilitation Facility

Indicates primary specialty

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NPI Profile & details for SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER

NPI # 1386107746

LBN Legal business name SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER

Authorized official JUDITH SIKORA - (CHIEF FINANCIAL OFFICER)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 04/11/2019

Last updated 04/11/2019 - About 7 years ago

Identifiers

Medicaid

100157670

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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