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GOOD SAMARITAN HOSPITAL

Counselor

Washington, Indiana

Provider NPI: 1043218613

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

Practice Location:
2007 STATE ST  WASHINGTON, IN 47501 US
Tel: 812-254-1558  Fax: 812-254-8308

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
N101Y00000XBehavioral Health & Social Service Providers
Counselor
IN4030
N101YA0400XBehavioral Health & Social Service Providers
Counselor
IN4030
N104100000XBehavioral Health & Social Service Providers
Social Worker
IN4030
N1041C0700XBehavioral Health & Social Service Providers
Social Worker
IN4030
N2084P0800XPhysicians
Psychiatry & Neurology
IN4030
N2084P0804XPhysicians
Psychiatry & Neurology
IN4030
N363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
IN4030
Y251S00000XAgencies
Community/Behavioral Health
IN4030CMHC

Other Provider Identifiers:

IssuerNumberStateType
ATHEM PIN FOR THIS LOCATION000000574031IN01
MAGELLAN151008000IN01
MHN GROUP165526IN01
100270140GIN05
VALUE OPTIONS301936IN01
100270140EIN05
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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