| Healthlinc - Porter-starke | |
|
701 Wall St Valparaiso IN 46383 | |
| (219) 299-8419 | |
| (219) 462-7504 |
| Full Name | Healthlinc - Porter-starke |
|---|---|
| Speciality | Clinic/Center |
| Location | 701 Wall St, Valparaiso, Indiana |
| Authorized Official Name and Position | Melissa Mitchell (CEO) |
| Authorized Official Contact | 2194659503 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthlinc - Porter-starke 2401 Valley Dr Valparaiso IN 46383-2520 Ph: (219) 413-5100 | Healthlinc - Porter-starke 701 Wall St Valparaiso IN 46383 Ph: (219) 299-8419 |
| NPI Number | 1023288032 |
|---|---|
| Provider Enumeration Date | 03/05/2008 |
| Last Update Date | 01/12/2024 |
| Medicare PECOS PAC ID | 7618929373 |
|---|---|
| Medicare Enrollment ID | O20080321000208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023288032 | NPI | - | NPPES |
| 200317310C | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | H80CS06662 (Indiana) | Primary |
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