NORTHSHORE HEALTH CENTERS INC. NPI 1417519000

NPI Information

NPI: 1417519000
Provider Name: NORTHSHORE HEALTH CENTERS, INC.

Doing Business As: NORTHSHORE LAPORTE HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
508 LEGACY PLZ W
LA PORTE, IN
ZIP 46350
Phone: (219) 728-1638
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NORTHSHORE HEALTH CENTERS, INC. is a federally qualified health center (fqhc) clinic center in La Porte, IN. NORTHSHORE HEALTH CENTERS, INC. NPI is 1417519000. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Northshore Laporte Health Center.

The provider's business location address is:

508 LEGACY PLZ W
LA PORTE, IN
ZIP 46350-254
Phone: (219) 728-1638
Fax: (219) 728-1639

The provider's authorized official is David Hall .
The authorized official title is Ceo and has the following contact phone number (219) 763-8112.

The enumeration date for this NPI number is 7/3/2019 and was last updated on 6/19/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	103TC0700X	Psychologist	Clinical	No
3	207Q00000X	Family Medicine		No
4	2084P0800X	Psychiatry & Neurology	Psychiatry	No
5	363LF0000X	Nurse Practitioner	Family	No
6	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	151054	OTHER	INDIANA	MEDICARE PTAN
2	300031202	MEDICAID	INDIANA
3	191360	OTHER	INDIANA	MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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