Organization
EDGEWATER SYSTEMS FOR BALANCED LIVING, INC
Active
Other names
Edgewater Health - Merrillville
Organization subpart
No
Provider details
NPI number
Authorized official
DANITA JOHNSON HUGHES (CEO)
(219) 885-4264
Entity
Organization
Contact information
Practice address
5495 BROADWAY, MERRILLVILLE, IN 46410-1647
(219) 985-5500
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
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
11/04/2020
Last updated
09/01/2023
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