Provider Demographics
NPI:1811650716
Name:COMMUNITY HEALTHNET INC
Entity type:Organization
Organization Name:COMMUNITY HEALTHNET INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:SEABROOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:218-880-1190
Mailing Address - Street 1:1021 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46402-1703
Mailing Address - Country:US
Mailing Address - Phone:219-880-1190
Mailing Address - Fax:219-880-0784
Practice Address - Street 1:5926 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320-2505
Practice Address - Country:US
Practice Address - Phone:219-880-1190
Practice Address - Fax:219-880-0784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health