| Healthlinc - South Bend (medical) | |
|
1960 Northside Boulevard South Bend IN 46615 | |
| (574) 307-7673 | |
| Not Available |
| Full Name | Healthlinc - South Bend (medical) |
|---|---|
| Speciality | Clinic/Center |
| Location | 1960 Northside Boulevard, South Bend, 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 - South Bend (medical) 951 Transport Dr Valparaiso IN 46383-8434 Ph: (219) 477-6082 | Healthlinc - South Bend (medical) 1960 Northside Boulevard South Bend IN 46615 Ph: (574) 307-7673 |
| NPI Number | 1790158244 |
|---|---|
| Provider Enumeration Date | 11/05/2015 |
| Last Update Date | 01/12/2024 |
| Medicare PECOS PAC ID | 7618929373 |
|---|---|
| Medicare Enrollment ID | O20160122000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790158244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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