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FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER INC

Addiction Substance Use Disorder

Logansport, Indiana

Provider NPI: 1972545945

Organization Information:
Organization Name:  FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER INC
Organization is not Subpart
Authorized Official:  JASON  CADWELL  CFO  574-7225151

Practice Location:
1015 MICHIGAN AVE  LOGANSPORT, IN 46947 US
Tel: 574-722-5151  Fax: 574-739-1414

Business Mailing Address:
800 FULTON ST C/O JASON CADWELL LOGANSPORT, IN 46947 US
Tel: 574-722-5151  Fax: 574-739-1414

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QM0801XAmbulatory Health Care Facilities
Clinic/Center
Mental Health (Including Community Mental Health Center)
IN427-0-CMHC
N261QR0400XAmbulatory Health Care Facilities
Clinic/Center
IN427-0-CMHC

Other Provider Identifiers:

IssuerNumberStateType
100464740IN05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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