Organization
SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER INC.
Active
Organization
SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER INC.
Active
Other names
PNW CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH SIKORA (CFO)
(219) 757-1921
Entity
Organization
Contact information
Practice address
2250 173RD ST STE 111, HAMMOND, IN 46323-2074
(219) 769-4005
Mailing address
8555 TAFT ST, MERRILLVILLE, IN 46410-6123
(219) 769-4005
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
02/24/2020
Last updated
02/26/2020
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