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Southlake Tricity Rba — NPI 1972637171, Lake Station, IN | NPI Central

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NPI 1972637171

OrganizationActive

Southlake Tricity Rba

NPI 1972637171 · Custodial Care Facility · Lake Station, IN

Provider details

NPI number: 1972637171
Entity type: Organization
Primary specialty: Custodial Care FacilityNursing & Custodial Care Facilities
Organization subpart: No
Authorized official: Robert Krumwied, Ceo(219) 392-6010

Specialties & taxonomies

Custodial Care FacilityPrimary311Z00000X
Nursing & Custodial Care Facilities

Practice location

2075 Ripley St

Lake Station, IN 46405-1161

Phone: (219) 962-9437

Approximate (ZIP-level) locationGet directions

More IN providers

Mailing address

2075 Ripley St

Lake Station, IN 46405-1161

Other names (DBA / former)

Doing business as: Lake Park Residential Care

Registry dates

Enumerated: 2007-03-16
Last updated: 2020-08-22

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.