| Otis R. Bowen Center | |
|
1535 Provident Dr. Warsaw IN 46580 | |
| (574) 267-7169 | |
| (574) 269-3995 |
| Full Name | Otis R. Bowen Center |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1535 Provident Dr., Warsaw, Indiana |
| Authorized Official Name and Position | Jay M Baumgartner (VP FISCAL DIVISION) |
| Authorized Official Contact | 5742677169 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Otis R. Bowen Center 850 N Harrison St Warsaw IN 46580-3163 Ph: (574) 267-7169 | Otis R. Bowen Center 1535 Provident Dr. Warsaw IN 46580 Ph: (574) 267-7169 |
| NPI Number | 1760521140 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760521140 | NPI | - | NPPES |
| 000000202972 | Other | IN | BLUE CROSS PROVIDER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 423-0-PIP (Indiana) | Primary |
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