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Organization

NORTHSHORE HEALTH CENTERS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID HALL (CEO)
(219) 763-8112
Entity
Organization

Contact information

Practice address
6050 STERLING CREEK RD., MOBILE UNIT, PORTAGE, IN 46368
(219) 763-8112
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
363L00000X
Nurse Practitioner

Other

Enumeration date
10/04/2023
Last updated
10/04/2023
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