Organization
SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC.
Active
Organization
SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER, INC.
Active
Other names
Regional Community Health Center- Homeless Site
Organization subpart
No
Provider details
NPI number
Authorized official
BOB KRUMWIED (CEO)
(219) 769-4005
Entity
Organization
Contact information
Practice address
527 STATE ST, HAMMOND, IN 46320-1533
(219) 803-7252
(219) 937-3300
Mailing address
8400 LOUISIANA ST, MERRILLVILLE, IN 46410-6385
(219) 757-1928
(219) 757-1950
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300020797
—
IN
Enumeration date
12/02/2013
Last updated
09/29/2025
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