Organization
LAKESHORE COMMUNITY OUTREACH INCORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLADYS FRYE (CHIEF EXECUTIVE OFFICER)
(219) 588-4511
Entity
Organization
Contact information
Practice address
730 CLINTON ST, GARY, IN 46406-1453
(219) 588-4511
(219) 898-2045
Mailing address
730 CLINTON ST, GARY, IN 46406-1453
(219) 588-4511
(219) 898-2045
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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