| Lakeside Behavioral Solutions | |
|
5944 1/2 Hohman Ave. Hammond IN 46320 | |
| (219) 801-1789 | |
| (219) 354-0356 |
| Full Name | Lakeside Behavioral Solutions |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5944 1/2 Hohman Ave., Hammond, Indiana |
| Authorized Official Name and Position | Cleotis White (CEO) |
| Authorized Official Contact | 2198011789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Behavioral Solutions 1804 E142 St. East Chicago IN 46312-3010 Ph: (219) 801-1789 | Lakeside Behavioral Solutions 5944 1/2 Hohman Ave. Hammond IN 46320 Ph: (219) 801-1789 |
| NPI Number | 1407108079 |
|---|---|
| Provider Enumeration Date | 10/08/2012 |
| Last Update Date | 10/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407108079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1636-0-ASO (Indiana) | Primary |
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