Organization
RESIDENTIAL CLINICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHMED A. MOHAMED DPT (ADMINISTRATOR/PRESIDENT)
(219) 736-5718
Entity
Organization
Contact information
Practice address
8102 GEORGIA ST FL 2, MERRILLVILLE, IN 46410-6225
(219) 736-5718
(219) 736-5720
Mailing address
103 W 78TH PL, MERRILLVILLE, IN 46410-5468
(219) 736-5718
(219) 736-5720
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
04-005307-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097953
ANTHEM
IN
01
—
079775500
US DEPT. OF LABOR
IN
05
—
100263870
—
IN
01
—
1022733
UNITED HEALTHCARE
IN
01
—
50393
BCBS OF ILLINOIS
IN
Enumeration date
06/23/2005
Last updated
08/13/2021
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