Organization
EDGEWATER SYSTEMS FOR BALANCED LIVING, INC
Active
Other names
NEW LIFE CENTER - EDGEWATER FOR BALANCED LIVING
Organization subpart
No
Provider details
NPI number
Authorized official
DANITA JOHNSON HUGHES (CEO)
(219) 885-4264
Entity
Organization
Contact information
Practice address
1110 W 5TH AVE, GARY, IN 46402-1723
(219) 885-4264
Mailing address
1110 W 5TH AVE, GARY, IN 46402-1723
(219) 885-4264
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM2800X
Methadone Clinic
—
—
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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