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General NPI Number Information
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NPI Number | 1184069569
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Entity Type | Organization
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Legal Business Name | HEALTHLINC, INC.
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 1313 W CHICAGO AVE
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City | EAST CHICAGO
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State | IN
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Zip | 46312
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Country | US
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Telephone | 219-398-9685
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Fax | 219-398-9695
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Provider Business Mailing Address
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Address Line | 2401 VALLEY DR
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City | VALPARAISO
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State | IN
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Zip | 46383-2520
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Country | US
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Telephone | 219-413-5100
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Fax | 219-465-9507
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Authorized Official
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Title or Position | CEO
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Name | MELISSA MITCHELL
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Credential |
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Telephone | 219-465-9503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | H80CS06662
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License Number State | IN
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