Edgewater Behavioral Health Services, Inc

LBN: Edgewater Systems For Balanced Living, Inc
Edgewater Behavioral Health Services, Inc is an health care organization with primary practice located at 4747 W 24Th Ave , Gary IN 46406. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder, Hospitals / Psychiatric Hospital, Residential Treatment Facilities / Substance Abuse Rehabilitation Facility. Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder is the primary health care specialty. Edgewater Systems For Balanced Living, Inc can be contacted via phone (219) 977-0110, or through Johnson-Hughes, Danita via phone (219) 881-2466.

Contact Information

Primary practice address
4747 W 24Th Ave Gary IN 46406
Phone: (219) 977-0110
Fax: (219) 427-1672
Website:
Map and Directions
Authorized official contact:
Name: Johnson-Hughes, Danita
Phone: (219) 881-2466

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X 421-009 Indiana
Hospitals / Psychiatric Hospital 283Q00000X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X

Profile Details

NPI number 1770960536
LBN Legal business name Edgewater Systems For Balanced Living, Inc
DBA Doing business as Edgewater Behavioral Health Services, Inc
Authorized official Johnson-Hughes, Danita
Entity Organization
Organization subpart 1 No
Enumeration date Apr 30th, 2015
Last updated Jun 16th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770960536 NPPES
Indiana MEDICAID 300013628

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