| Mulberry Center, Inc. | |
|
414 Se 4th St Evansville IN 47713-1206 | |
| (812) 423-4700 | |
| (812) 421-2618 |
| Full Name | Mulberry Center, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 414 Se 4th St, Evansville, Indiana |
| Authorized Official Name and Position | Michael Carroll (ACTING EXEC DIRECTOR) |
| Authorized Official Contact | 8124364231 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mulberry Center, Inc. 414 Se 4th St Evansville IN 47713-1206 Ph: (812) 423-4700 | Mulberry Center, Inc. 414 Se 4th St Evansville IN 47713-1206 Ph: (812) 423-4700 |
| NPI Number | 1407919848 |
|---|---|
| Provider Enumeration Date | 12/18/2006 |
| Last Update Date | 04/01/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407919848 | NPI | - | NPPES |
| 200453230A | Medicaid | IN | |
| 200453230 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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