| Edgewater Systems For Balanced Living, Inc | |
|
9855 Lincoln Plaza Way Unit 5a, Cedar Lake IN 46303 | |
| (219) 885-4264 | |
| Not Available |
| Full Name | Edgewater Systems For Balanced Living, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9855 Lincoln Plaza Way Unit 5a,, Cedar Lake, Indiana |
| Authorized Official Name and Position | Danita Johnson Hughes (CEO) |
| Authorized Official Contact | 2198854264 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edgewater Systems For Balanced Living, Inc 1100 W 6th Ave Gary IN 46402-1711 Ph: () - | Edgewater Systems For Balanced Living, Inc 9855 Lincoln Plaza Way Unit 5a, Cedar Lake IN 46303 Ph: (219) 885-4264 |
| NPI Number | 1164181947 |
|---|---|
| Provider Enumeration Date | 12/09/2021 |
| Last Update Date | 12/09/2021 |
| Medicare PECOS PAC ID | 9234398397 |
|---|---|
| Medicare Enrollment ID | O20211213000745 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164181947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
219 Health Network, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13963 Morse St Ste B, Cedar Lake, IN 46303 Phone: 219-374-5555 Fax: 219-374-6669 | |
Sik Med Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10120 Homestead Ct, Cedar Lake, IN 46303 Phone: 347-564-6379 | |
Jon D. Misch, D.o.,p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13963 Morse St, Cedar Lake, IN 46303 Phone: 219-374-5555 Fax: 219-374-6669 |