Organization · NPI-2

219 Health Network, INC.

Clinic/Center, Federally Qualified Health Center (FQHC) · Cedar Lake, IN

NPI number1669104964
StatusActive
Last updated in NPPESAug 16, 2024

Details

NPI
1669104964
Entity type
Organization (NPI-2)
Legal business name
219 Health Network, INC.
Organization subpart
No
Enumeration date
Jun 27, 2022
Certification date
Aug 16, 2024
Last updated
Aug 16, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC)––Yes
207Q00000X Family Medicine––
207R00000X Internal Medicine––
363LF0000X Nurse Practitioner, Family––

Practice location

13963 Morse St Ste B
Cedar Lake, IN 46303-9639

Phone 219-374-5555 · Fax 219-374-6669

Mailing address

100 W Chicago Ave Ste F
East Chicago, IN 46312-3261

Phone 219-392-7016 · Fax 219-392-6904

Authorized official

William Cortes
Executive Director
2197032585

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