Organization
NORTHSHORE HEALTH CENTERS, INC.
Active
Other names
NorthShore LaPorte High School Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HALL (CEO)
(219) 763-8112
Entity
Organization
Contact information
Practice address
602 F STREET, RM G.15, LAPORTE, IN 46350-5526
(219) 763-8112
(219) 764-5380
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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