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SAMARITAN CENTER

Addiction Substance Use Disorder

Loogootee, Indiana

Provider NPI: 1679571228

Organization Information:
Organization Name:  SAMARITAN CENTER
Organization is Subpart
Authorized Official:  JOHN  MANNING  VP BEHAVIORAL HEALTH/SPEC PROJECTS  812-8866800

Practice Location:
200 S JFK AVE  LOOGOOTEE, IN 47553 US
Tel: 812-295-3090  Fax: 812-295-4328

Business Mailing Address:
515 BAYOU ST  VINCENNES, IN 47591 US
Tel: 812-886-6800  Fax: 812-886-6809

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
IN403-0
N1041C0700XBehavioral Health & Social Service Providers
Social Worker
IN403-0
N2084P0800XPhysicians
Psychiatry & Neurology
IN403-0
Y251S00000XAgencies
Community/Behavioral Health
IN403-0-CMHC

Other Provider Identifiers:

IssuerNumberStateType
ANTHEM PIN FOR THIS LOCATION000000574037IN01
VALUE OPTIONS FACILITY301936IN01
100270140GIN05
MAGELLAN192467000IN01
100270140BIN05
MHN GROUP165526IN01
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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