| Center For Behavioral Medicine | |
|
600 East Blvd Elkhart IN 46514-2483 | |
| (574) 523-3200 | |
| (574) 389-4860 |
| Full Name | Center For Behavioral Medicine |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 600 East Blvd, Elkhart, Indiana |
| Authorized Official Name and Position | Jeffrey Costello (CFO) |
| Authorized Official Contact | 5746743460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Behavioral Medicine 600 East Blvd Elkhart IN 46514-2483 Ph: (574) 942-6212 | Center For Behavioral Medicine 600 East Blvd Elkhart IN 46514-2483 Ph: (574) 523-3200 |
| NPI Number | 1619975554 |
|---|---|
| Provider Enumeration Date | 07/13/2005 |
| Last Update Date | 12/01/2022 |
| Certification Date | 12/01/2022 |
| Medicare PECOS PAC ID | 4688571169 |
|---|---|
| Medicare Enrollment ID | O20140708000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619975554 | NPI | - | NPPES |
| 100268340A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 05-005017-1 (Indiana) | Primary |
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