| Shalom Health Care Center, Inc. | |
|
3400 Lafayette Road Suite 200 Indianapolis IN 46222-1147 | |
| (317) 291-7422 | |
| (317) 291-7433 |
| Full Name | Shalom Health Care Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3400 Lafayette Road, Indianapolis, Indiana |
| Authorized Official Name and Position | Leonardo R Ortega (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3172917422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shalom Health Care Center, Inc. 3400 Lafayette Road Suite 200 Indianapolis IN 46222-1147 Ph: (317) 291-7422 | Shalom Health Care Center, Inc. 3400 Lafayette Road Suite 200 Indianapolis IN 46222-1147 Ph: (317) 291-7422 |
| NPI Number | 1992924633 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 01/22/2021 |
| Medicare PECOS PAC ID | 3779471750 |
|---|---|
| Medicare Enrollment ID | O20040310000486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992924633 | NPI | - | NPPES |
| 200392480 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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