Organization
EDGEWATER SYSTEMS FOR BALANCED LIVING, INC
Active
Other names
Primary Care-Griffith
Organization subpart
No
Provider details
NPI number
Authorized official
DANITA JOHNSON HUGHES (CEO)
(219) 885-4264
Entity
Organization
Contact information
Practice address
1212 N BROAD ST, GRIFFITH, IN 46319-1534
(219) 838-1270
Mailing address
1100 W 6TH AVE, GARY, IN 46402-1711
(219) 885-4264
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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