SHALOM HEALTH CARE CENTER INC. NPI 1003275512

NPI Information

SHALOM HEALTH CARE CENTER, INC. is a federally qualified health center (fqhc) clinic center in Indianapolis, IN. SHALOM HEALTH CARE CENTER, INC. NPI is 1003275512. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Shalom 56th Street-new Access Point.

The provider's business location address is:

5750 W 56TH ST
INDIANAPOLIS, IN
ZIP 46254-695
Phone: (317) 291-7422
Fax: (317) 291-4912

The provider's authorized official is Leonardo R Ortega .
The authorized official title is Ceo/executive Director and has the following contact phone number (317) 291-7422.

The CLIA number assigned to this NPI record is 15D2222890 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/12/2016 and was last updated on 1/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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