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Organization

DOCKSIDE SERVICES, LLC

Active
Other names
Clarvida
Organization subpart
No

Provider details

NPI number
Authorized official
MARY MIMS (EXECUTIVE DIRECTOR)
(708) 903-7689
Entity
Organization

Contact information

Practice address
2614 LINCOLN HWY, MERRILLVILLE, IN 46410-5235
(219) 513-3960
(219) 838-8020
Mailing address
2614 LINCOLN HWY, MERRILLVILLE, IN 46410-5235
(219) 513-3960
(219) 838-8020

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
370346298 53782
IN
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200297360A
IN
Enumeration date
02/23/2007
Last updated
02/05/2026
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