ST
SOUTHLAKE TRICITY RBA
Custodial Care Facility
OIG CLEARNPI VERIFIED
Location
LAKE STATION, IN
Licensed since
2007
Rate
—
Federal identifiers
NPI registry number1972637171
Agency details
Medicare activity
StatusNo Medicare utilization on file — neutral.
Authorized official
NameROBERT KRUMWIED
TitleCEO
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