Organization · Type 2 NPI

Edgewater Systems for Balanced Living, Inc

Substance Use Disorder Rehabilitation Clinic/Center · Gary, IN

NPI number 1770960536 Active

Practice location

4747 W 24th Ave
Gary, IN 46406

Call (219) 977-0110 Map

Fax (219) 427-1672

Mailing address

1100 W 6th Ave
Gary, IN 46402-1711

Specialties and licenses

Taxonomy	Code	License
Substance Use Disorder Rehabilitation Clinic/Center Primary	261QR0405X	421-009 (IN)
Psychiatric Hospital	283Q00000X	None listed
Substance Abuse Rehabilitation Facility	324500000X	None listed

Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...

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NPI record

NPI: 1770960536
Entity type: Organization (Type 2)
Issued: Apr 30, 2015
Last updated: Jun 16, 2018
Status: Active

Other names

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Edgewater Health Rapid Access Center · doing business as
Edgewater Behavioral Health Services, Inc · doing business as
Edgewater Behavioral Health Services, Inc · doing business as

Authorized official

Danita Johnson-Hughes
CEO
(219) 881-2466

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1770960536

Edgewater Systems for Balanced Living, Inc's National Provider Identifier is 1770960536, issued on Apr 30, 2015. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Gary, IN. The record was last updated on Jun 16, 2018.