Overview
Name: EDGEWATER SYSTEMS FOR BALANCED LIVING, INC
Specialty: Federally Qualified Health Center (FQHC)
Type of Practice: Organization
Provider/Org:
Medical School:
Graduation year from medical school:
Affiliation:
Specialties
Practice Type: Ambulatory Health Care Facilities
Classification: Clinic/Center
Specialization: Federally Qualified Health Center (FQHC).
Definition of Specialty: Definition to come…
License & NPI
License #(s): , , , ,
License State(s): , , , ,
Addresses
Practice Location: EDGEWATER SYSTEMS FOR BALANCED LIVING, INC,EDGEWATER HEALTH: LAKE STREET PEDIATRICS,426 S LAKE ST,GARY,IN,464032405,US
Mailing Address: EDGEWATER SYSTEMS FOR BALANCED LIVING, INC,EDGEWATER HEALTH: LAKE STREET PEDIATRICS,1100 W 6TH AVE,GARY,IN,464021711,US
Contact #
Practice location phone #: 2199396070
Practice location fax #:
Mailing address Phone #: 2198854264
Mailing Address fax #:
Authorized official Name/Telephone #:DANITA, JOHNSON, HUGHES, CEO 2198854264
Misc
Date NPI was obtained: 08/26/2021
Last data data was updated: 08/26/2021
Insurances: