| Madison Center, Inc. | |
|
403 E Madison St South Bend IN 46617-2322 | |
| (574) 234-0061 | |
| (574) 283-1209 |
| Full Name | Madison Center, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 403 E Madison St, South Bend, Indiana |
| Authorized Official Name and Position | Brenda J Clanton (CONTRACTS MANAGER) |
| Authorized Official Contact | 5742831107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Center, Inc. 403 E Madison St South Bend IN 46617-2322 Ph: (574) 234-0061 | Madison Center, Inc. 403 E Madison St South Bend IN 46617-2322 Ph: (574) 234-0061 |
| NPI Number | 1174671952 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 04/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174671952 | NPI | - | NPPES |
| 100451660A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 406-14-PIP (Indiana) | Primary |
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