SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER INC. (NPI# 1972092047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972092047 |
| Entity Type | Organization |
| Organization Name | SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER INC. |
| Practice Address |
3903 Indianapolis Blvd East Chicago IN 46312 |
| Mailing Address |
8400 Louisiana St Merrillville IN 46410-6385 |
| Practice Telephone | 2193987050 |
| Practice Fax Number | 2193923998 |
| Mailing Telephone | 2197571924 |
| Mailing Fax Number | 2197571950 |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2018-06-12 |
| Authorized Official Name | SHIRLEY A ROLL (ENROLLMENT) |
| Authorized Official Telephone | 3174727396 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
424-014 | IN | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023642576 | Southlake Community Mental Health Center Inc. | Clinic/Center | 2250 173rd St Ste 111, Hammond, IN 46323-2074 | 2020-02-24 |
| 1548407216 | Southlake Community Mental Health Center Inc. | Psychiatric Hospital | 8555 Taft St, Merrillville, IN 46410-6123 | 2009-01-16 |
| 1821081290 | Southlake Community Mental Health Center Inc. | Clinic/Center | 8555 Taft St, Merrillville, IN 46410-6123 | 2005-08-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER INC | 8555 Taft Street, Merrillville, IN 46410 |
| Street Address |
3903 INDIANAPOLIS BLVD |
| City | EAST CHICAGO |
| State | IN |
| Zip Code | 46312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801888037 | Samina Niaz Khattak | Psychiatry & Neurology | 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 | 2005-08-15 |
| 1891333803 | Kathleen Weir | Psychiatry & Neurology | 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 | 2019-12-20 |
| 1508340936 | Sefelisha Harmon | Nurse Practitioner | 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 | 2018-09-21 |
| 1215440060 | Rondi Wightman | Social Worker | 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 | 2017-11-14 |
| 1215449491 | Rochelle Grieger | Pharmacist | 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 | 2017-10-28 |
| 1962860775 | Emily Brown | Psychologist | 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 | 2016-02-08 |
| 1376919217 | Southlake Community Mental Health Center, Inc | Clinic/Center | 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 | 2015-08-14 |
| 1699114033 | Laura Uzelac | Counselor | 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 | 2013-06-19 |
| 1952651408 | Valerie Perez | Psychologist | 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 | 2012-09-12 |
| 1548536196 | Lolita O Ang | Psychiatry & Neurology | 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 | 2012-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578025896 | 219 Health Network Inc | Clinic/Center | 4320 First Street, Suite 211, East Chicago, IN 46312 | 2019-04-04 |
| 1932663051 | Melissa Lynn Del Rosario | Registered Nurse | St. Catherine Hospital, 4321 Fir St, East Chicago, IN 46312 | 2019-01-23 |
| 1851896013 | Scot Eric West | Registered Nurse | 4320 Fir St Unit 217, East Chicago, IN 46312 | 2018-03-28 |
| 1528598380 | Wellnes for Life | Clinic/Center | 1401 144th St, East Chicago, IN 46312 | 2017-06-14 |
| 1992116305 | Familia Dental Ec LLC | Dentist | 4624a Magoun Avenue, East Chicago, IN 46312 | 2014-05-20 |
| 1821415076 | Ericka Rouse | Counselor | 901 West Chicago Ave., East Chicago, IN 46312 | 2014-03-26 |
| 1568806057 | St. Catherine Hospital Inc. | Pharmacy | 4321 Fir St., East Chicago, IN 46312 | 2013-04-26 |
| 1275882185 | Planned Parenthood of Indiana East Chicago | Clinic/Center | 3931 Main Street, East Chicago, IN 46312 | 2012-09-06 |
| 1851417356 | Deborah Ann Duda | Nurse Practitioner | 1155 E Alexis, Toledo, OH 46312 | 2007-03-22 |
| 1255457826 | Major Hospital | Skilled Nursing Facility | 5025 Mccook Ave, East Chicago, IN 46312 | 2007-03-22 |
| Find all providers in zip 46312 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285265470 | Our Place Drug and Alcohol Education Services, Inc. | Clinic/Center | 400 E Spring St, New Albany, IN 47150-2920 | 2020-01-28 |
| 1083250542 | Avenues Recovery Center of Fort Wayne, LLC | Clinic/Center | 2626 Fairfield Ave, Fort Wayne, IN 46807-1215 | 2019-11-20 |
| 1518447309 | Wellpoint Recovery LLC | Clinic/Center | 3930 Mezzanine Dr Ste B, Lafayette, IN 47905-8646 | 2018-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1811483308 | Indiana Recovery Centers LLC | Clinic/Center | 1130 W Jefferson St Ste B, Franklin, IN 46131-2760 | 2018-07-08 |
| 1992221949 | The Happiness Project, LLC | Clinic/Center | 8412 Leesburg Rd, Fort Wayne, IN 46818-9125 | 2017-08-21 |
| 1457897647 | Pinnacletreatment Centers In-1, LLC | Clinic/Center | 2060 North State Rd 1, Cambridge City, IN 47327 | 2017-01-11 |
| 1326494758 | Pinnacle Treatment Centers In-1, LLC D/b/a Recovery Works Merrillville | Clinic/Center | 201 W 89th Ave, Merrillville, IN 46410-6283 | 2016-05-04 |
| 1568834992 | Parkdale Center LLC | Clinic/Center | 350 Indian Boundary Rd, Chesterton, IN 46304-1511 | 2015-10-26 |
| 1194108969 | A New Day Treatment Services Inc | Clinic/Center | 2731 Albright Rd, Kokomo, IN 46902-3996 | 2015-06-29 |
| Find all providers with the same taxonomy | ||||
| City | EAST CHICAGO |
| Zip Code | 46312 |
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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.