Regional Health Clinic

LBN: Southlake Community Mental Health Center, Inc
Regional Health Clinic is an health care organization with primary practice located at 4022 Hohman Ave , Hammond IN 46327. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Southlake Community Mental Health Center, Inc can be contacted via phone (219) 937-3300, or through Krumwied, Robert via phone (219) 736-7183.

Contact Information

Primary practice address
4022 Hohman Ave Hammond IN 46327
Phone: (219) 937-3300
Fax: (219) 803-7252
Website:
Map and Directions
Authorized official contact:
Name: Krumwied, Robert
Phone: (219) 736-7183

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1609231927
LBN Legal business name Southlake Community Mental Health Center, Inc
DBA Doing business as Regional Health Clinic
Authorized official Krumwied, Robert
Entity Organization
Organization subpart 1 No
Enumeration date Dec 31st, 2015
Last updated Jul 1st, 2016 - about 9 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 1609231927 NPPES
Indiana Other 15D2108285 CLIA
Indiana MEDICAID 201323280 CLIA

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