EDGEWATER SYSTEMS FOR BALANCED LIVING, INC (NPI# 1548861313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548861313 |
| Entity Type | Organization |
| Organization Name | EDGEWATER SYSTEMS FOR BALANCED LIVING, INC |
| Practice Address |
1100 W 5th Ave Gary IN 46402-1723 |
| Mailing Address |
1100 W 6th Ave Gary IN 46402-1711 |
| Practice Telephone | 2198854626 |
| Mailing Telephone | 2198854264 |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2020-11-06 |
| Authorized Official Name | DANITA JOHNSON HUGHES (CEO) |
| Authorized Official Telephone | 2198854264 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Turning Point | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366043457 | Edgewater Systems for Balanced Living, Inc | Clinic/Center | 1212 N Broad St, Griffith, IN 46319-1534 | 2020-11-04 |
| 1407457591 | Edgewater Systems for Balanced Living, Inc | Clinic/Center | 3535 Broadway, Gary, IN 46409-1316 | 2020-11-04 |
| 1932732955 | Edgewater Systems for Balanced Living, Inc | Clinic/Center | 1110 W 5th Ave, Gary, IN 46402-1723 | 2020-02-18 |
| 1598316978 | Edgewater Systems for Balanced Living, Inc | Clinic/Center | 1100 W 6th Ave, Gary, IN 46402-1711 | 2019-09-26 |
| 1568955037 | Edgewater Systems for Balanced Living, Inc | Psychiatric Hospital | 1110 W 5th Ave, Gary, IN 46402-1723 | 2018-06-11 |
| 1770960536 | Edgewater Systems for Balanced Living, Inc | Psychiatric Hospital | 4747 W 24th Ave, Gary, IN 46406 | 2015-04-30 |
| 1316154917 | Edgewater Systems for Balanced Living, Inc | Community/Behavioral Health | 1100 W 6th Ave, Gary, IN 46402-1711 | 2007-05-16 |
| 1225245822 | Edgewater Systems for Balanced Living, Inc | Community/Behavioral Health | 1100 W 6th Ave, Gary, IN 46402-1711 | 2007-05-16 |
| Street Address |
1100 W 5TH AVE |
| City | GARY |
| State | IN |
| Zip Code | 46402-1723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790154417 | Edgewater Systerms for Balanced Living | Community/Behavioral Health | 1106 West 6 Th Avenue, Gary, IN 46402 | 2015-09-23 |
| 1447642772 | Michael Pirtle | Counselor | 1100 W. Fifth Ave, Gary, IN 46402 | 2015-02-24 |
| 1356748370 | Peter F Uchman | Social Worker | 1100 W. 6th Ave., Gary, IN 46402 | 2014-11-20 |
| 1295142594 | Demetria A Macon | Counselor | 1100 W. 6th Ave, Gary, IN 46402 | 2014-07-18 |
| 1396952503 | 21st Century Charter School At Gary | Local Education Agency (LEA) | 556 W Washington, Gary, IN 46402 | 2007-05-17 |
| 1609094630 | Jomon Mathew | Physical Therapist | 353 Tyler St, Gary, IN 46402 | 2007-04-23 |
| 1376677138 | Kovilparambil Xavier Antony | Psychiatry & Neurology | 1100 W 6th Avenue, Gary, IN 46402 | 2007-03-15 |
| 1588759013 | Waltee Douglas | Psychologist | 667 Van Buren, Gary, IN 46402 | 2006-10-03 |
| 1851332514 | Thessa Grace Robertson | Emergency Medicine | 600 Grant Street, Gary, IN 46402 | 2006-06-10 |
| 1932672888 | The Methodist Hospitals, Inc | Pharmacy | 600 Grant St, Gary, IN 46402 | 2019-01-03 |
| Find all providers in zip 46402 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003371220 | Porter Starke Services Inc | Clinic/Center | Marram Health Center, 3229 Broadway Suite 160, Gary, IN 46409-1040 | 2019-02-01 |
| 1891262762 | Community Healthnet Inc | Clinic/Center | 3503 Martin Luther King Drive, Community Healthnet Inc - East, Gary, IN 46409-1233 | 2018-10-30 |
| 1023485356 | Porter-starke Services Inc. | Clinic/Center | 3229 Broadway Ste 115, Gary, IN 46409-1040 | 2015-08-21 |
| 1548382435 | Tug River Health Association | Clinic/Center | Rt 103 Supply St, Gary, WV 24836 | 2007-04-04 |
| 1922184266 | Tug River Health Association, Inc | Clinic/Center | Route 103 Supply St., Gary, WV 24836 | 2006-10-30 |
| 1174501068 | Tug River Health Association, Inc | Clinic/Center | Us Rt 52 Main Street, Gary, WV 24836 | 2006-01-03 |
| 1407457591 | Edgewater Systems for Balanced Living, Inc | Clinic/Center | 3535 Broadway, Gary, IN 46409-1316 | 2020-11-04 |
| 1598316978 | Edgewater Systems for Balanced Living, Inc | Clinic/Center | 1100 W 6th Ave, Gary, IN 46402-1711 | 2019-09-26 |
| 1639578065 | Tug River Health Association, Inc. | Clinic/Center | Rr 103 Supply Street, Gary, WV 24836-0507 | 2014-08-21 |
| 1497007876 | Community Healthnet | Clinic/Center | 1015 N Shelby St, Gary, IN 46403-1446 | 2012-10-09 |
| Find all providers in GARY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.