East Indiana Treatment Center

NPI 1013060714 - Clinic/Center - 261QM2800X

NPI Details
NPI 1013060714
Enumeration Date 01/18/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MARY ANN MARY ANN
Position CLINIC DIRECTOR
Phone (812) 537-1668
Fax (812) 539-2368
Practice Location
816 RUDOLPH WAY
GREENDALE IN, 47025-8312, US
Phone (812) 537-1668
Fax (812) 539-2368
Business Location
816 RUDOLPH WAY
GREENDALE IN, 47025-8312, US
Phone (812) 537-1668
Fax (812) 539-2368
Toxanomy
Taxonomy Code 261QM2800X
License State Indiana
License Number 10780ASR
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According to our database, East Indiana Treatment Center NPI is 1013060714, taxonomy code is 261QM2800X and license number is 10780ASR, license state is located at Indiana. East Indiana Treatment Center physically located at 816 Rudolph Way, Greendale IN, 47025-8312. NPI Number 1033115704 has the healthcare provider type.

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1013060714 NPI number is provided on an as is basis without warranty of any kind. 1013060714 is maintained by the National Plan & Provider Enumeration System. The contents of East Indiana Treatment Center are for informational purposes only.