Organization
SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC
Active
Organization
SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH K SIKORA (CFO)
(219) 757-1921
Entity
Organization
Contact information
Practice address
8555 TAFT ST, MERRILLVILLE, IN 46410-6123
(219) 769-4500
(219) 757-1950
Mailing address
8400 LOUISIANA ST, MERRILLVILLE, IN 46410-6385
(219) 757-1924
(219) 757-1950
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
424-0-ASR
IN
Other
Enumeration date
02/14/2018
Last updated
02/14/2018
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