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Organization
SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER
Active
Organization
SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER
Active
Parent organization
SOUTHLAKE COMMUNITY MENTAL HEALTH CNTR
Other names
Regional Mental Health Centers
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHLAKE COMMUNITY MENTAL HEALTH CNTR
Authorized official
MRS. JUDITH K SIKORA (CHIEF FINANCIAL OFFICER)
(219) 757-1921
Entity
Organization
Contact information
Practice address
8555 TAFT ST, MERRILLVILLE, IN 46410-6123
(219) 769-4005
(219) 757-1950
Mailing address
8400 LOUISIANA ST, MERRILLVILLE, IN 46410-6385
(219) 757-1939
(219) 757-1950
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100157670
—
IN
Enumeration date
04/11/2019
Last updated
04/11/2019
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