Organization
SHALOM HEALTH CARE CENTER, INC.
Active
Organization
SHALOM HEALTH CARE CENTER, INC.
Active
Other names
Shalom 56th Street-New Access Point
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARDO R ORTEGA M.D., M.P.H. (CEO/EXECUTIVE DIRECTOR)
(317) 291-7422
Entity
Organization
Contact information
Practice address
5750 W 56TH ST, INDIANAPOLIS, IN 46254-1695
(317) 291-7422
(317) 291-4912
Mailing address
3400 LAFAYETTE RD STE 200, INDIANAPOLIS, IN 46222-1147
(317) 291-7422
(317) 291-4912
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200392480
—
IN
05
—
200392480J
—
IN
Enumeration date
02/12/2016
Last updated
03/30/2026
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