| Tri-state Behavioral Health Llc | |
|
1116 Millis Ave St. Mary's Warrick Boonville IN 47601 | |
| (812) 962-2353 | |
| (812) 962-0915 |
| Full Name | Tri-state Behavioral Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1116 Millis Ave, Boonville, Indiana |
| Authorized Official Name and Position | Anjum Shehzad Ashraf (MEMBER) |
| Authorized Official Contact | 8129622353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-state Behavioral Health Llc 1900 Waters Ridge Dr Newburgh IN 47630-8084 Ph: (812) 962-2353 | Tri-state Behavioral Health Llc 1116 Millis Ave St. Mary's Warrick Boonville IN 47601 Ph: (812) 962-2353 |
| NPI Number | 1902073554 |
|---|---|
| Provider Enumeration Date | 05/13/2008 |
| Last Update Date | 04/11/2013 |
| Medicare PECOS PAC ID | 8123034998 |
|---|---|
| Medicare Enrollment ID | O20080603000787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902073554 | NPI | - | NPPES |
| 200478750 A | Medicaid | IN | |
| 234630 | Other | IN | MEDICARE - ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 01048619A (Indiana) | Primary |
| Provider Name | Anjum S Ashraf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700833191 PECOS PAC ID: 3678568920 Enrollment ID: I20040823000410 |
Family Counseling Service, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1116 Millis Ave, Boonville, IN 47601 Phone: 812-897-7131 Fax: 812-897-7456 | |
Ascension St. Vincent Warrick Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1116 Millis Avenue, Boonville, IN 47601 Phone: 812-897-4800 Fax: 812-897-7375 |