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611 E Main St Suite 110 Petersburg IN 47567-1267 | |
(812) 354-8785 | |
(812) 354-8786 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 611 E Main St, Petersburg, Indiana |
Authorized Official Name and Position | John Manning (VP BEHAVIORAL HEALTH/SPEC PROJECTS) |
Authorized Official Contact | 8128866800 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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515 Bayou St Vincennes IN 47591-1034 Ph: (812) 886-6800 | 611 E Main St Suite 110 Petersburg IN 47567-1267 Ph: (812) 354-8785 |
NPI Number | 1952309528 |
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Provider Enumeration Date | 07/08/2005 |
Last Update Date | 06/03/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952309528 | NPI | - | NPPES |
165526 | Other | IN | MHN GROUP |
192466000 | Other | IN | MAGELLAN |
000000574039 | Other | IN | ANTHEM PIN FOR THIS LOCATION |
301936 | Other | IN | VALUE OPTIONS FACILITY |
100270140C | Medicaid | IN | |
100270140G | Medicaid | IN |