SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC. is a federally qualified health center (fqhc) clinic center in Hammond, IN. SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC. NPI is 1508297540. The provider is registered as an organization entity type.
The provider Is Doing Business As Regional Community Health Center- Homeless Site.
The provider's business location address is:
527 STATE ST
HAMMOND, IN
ZIP 46320-533
Phone: (219) 803-7252
Fax: (219) 937-3300
The provider's authorized official is Bob Krumwied .
The authorized official title is Ceo and has the following contact phone number (219) 769-4005.
The CLIA number assigned to this NPI record is 15D0886011 - other with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 12/2/2013 and was last updated on 5/8/2014.