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NPI Code Detail

MEDICARE: CENTER FOR BEHAVIORAL HEALTH INDIANA LLC

MEDICARE: CENTER FOR BEHAVIORAL HEALTH INDIANA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM2800XMethadone Clinic

General Provider Information

NPI Number : 1134559917
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTER FOR BEHAVIORAL HEALTH INDIANA LLC
Provider Business Mailing Address
First Line : 5001 SPRING VALLEY ROAD
Second Line : SUITE 600 EAST
City : DALLAS
State : TX
Zip : 75244-3946
Country : US
Telephone Number : 214-365-6100
Fax Number : 214-365-6150
Provider Business Practice Location Address
First Line : 3910 LIMA RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-1031
Country : US
Telephone Number : 260-420-6010
Fax Number :
Authorized Official
Title or Position : CEO
Name : JAY HIGHAM
Credential :
Telephone Number : 214-365-6112
Provider Enumeration Date : 11/15/2013
Last Update Date : 12/26/2024

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Directions to “CENTER FOR BEHAVIORAL HEALTH INDIANA LLC ” Practice Location

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