Northshore Health Centers, INC.
Clinic/Center, Federally Qualified Health Center (FQHC) in Lake Station, IN. Organization (NPI-2).
NPI number1861636664
StatusActive
Last updated in NPPESNov 12, 2020
Details
- NPI
- 1861636664
- Entity type
- Organization (NPI-2)
- Legal business name
- Northshore Health Centers, INC.
- Organization subpart
- No
- Enumeration date
- Apr 23, 2009
- Certification date
- Nov 12, 2020
- Last updated
- Nov 12, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | |
| 1041C0700X | Social Worker, Clinical | – | – | |
| 152W00000X | Optometrist | – | – | |
| 207Q00000X | Family Medicine | – | – | |
| 207V00000X | Obstetrics & Gynecology | – | – | |
| 208000000X | Pediatrics | – | – | |
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | |
| 2084P0804X | Psychiatry & Neurology, Child & Adolescent Psychiatry | – | – | |
| 2085R0202X | Radiology, Diagnostic Radiology | – | – | |
| 2085U0001X | Radiology, Diagnostic Ultrasound | – | – | |
| 363L00000X | Nurse Practitioner | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – | |
| 363LW0102X | Nurse Practitioner, Women's Health | – | – | |
| 367A00000X | Advanced Practice Midwife | – | – |
Practice location
2490 Central AveLake Station, IN 46405-2122
Phone 219-763-8112 · Fax 219-962-1580
Mailing address
Po Box 1430Portage, IN 46368-9230
Phone 219-763-8112 · Fax 219-764-5380
Authorized official
David Hall
Ceo
2197638112
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