| Radiant Health Services | |
|
505 N Wabash Ave Marion IN 46952-2608 | |
| (765) 662-3971 | |
| (765) 662-7480 |
| Full Name | Radiant Health Services |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 505 N Wabash Ave, Marion, Indiana |
| Authorized Official Name and Position | Lisa A. Dominisse (CEO) |
| Authorized Official Contact | 7656686713 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiant Health Services 505 N Wabash Ave Marion IN 46952-2608 Ph: (765) 662-3971 | Radiant Health Services 505 N Wabash Ave Marion IN 46952-2608 Ph: (765) 662-3971 |
| NPI Number | 1952447013 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 09/08/2023 |
| Certification Date | 09/08/2023 |
| Medicare PECOS PAC ID | 9739177528 |
|---|---|
| Medicare Enrollment ID | O20210826003535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952447013 | NPI | - | NPPES |
| 100273390 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 414-0-CMHC (Indiana) | Primary |
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