Healthcare Provider Details

I. General information

NPI: 1265347793
Provider Name (Legal Business Name): SOLARA MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CADENCE PARK PLZ STE 146
MICHIGAN CITY IN
46360-3332
US

IV. Provider business mailing address

1 CADENCE PARK PLZ STE 146
MICHIGAN CITY IN
46360-3332
US

V. Phone/Fax

Practice location:
  • Phone: 219-840-3008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAKIF AHMED
Title or Position: OWNER
Credential: APRN
Phone: 708-486-2700