Organization
EDGEWATER SYSTEMS FOR BALANCED LIVING, INC
Active
Organization
EDGEWATER SYSTEMS FOR BALANCED LIVING, INC
Active
Other names
Edgewater Systems
Organization subpart
No
Provider details
NPI number
Authorized official
DANITA JOHNSON HUGHES (PRESIDENT & CEO)
(219) 885-4264
Entity
Organization
Contact information
Practice address
1100 W 6TH AVE, GARY, IN 46402-1711
(219) 885-4264
(219) 888-9867
Mailing address
1100 W 6TH AVE, GARY, IN 46402-1711
(219) 885-4264
(219) 888-9867
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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