Organization
INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL INC
Active
Other names
Community Health Center of LaPorte
Organization subpart
No
Provider details
NPI number
Authorized official
G THOR THORDARSON (PRESIDENT/CEO)
(219) 326-2555
Entity
Organization
Contact information
Practice address
400 TEEGARDEN, LA PORTE, IN 46350-3175
(219) 326-2403
(219) 326-2385
Mailing address
400 TEEGARDEN, LA PORTE, IN 46350-3175
(219) 326-2403
(219) 326-2385
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
06-005006-1
IN
261QD0000X
Dental Clinic/Center
Primary
11-005006-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200237780A
—
IN
Enumeration date
11/03/2006
Last updated
09/16/2013
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