Healthcare Provider Details

I. General information

NPI: 1669540951
Provider Name (Legal Business Name): THE CENTER FOR MENTAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2006
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 BROWN ST
ANDERSON IN
46016-4218
US

IV. Provider business mailing address

PO BOX 1258
ANDERSON IN
46015-1258
US

V. Phone/Fax

Practice location:
  • Phone: 765-649-8161
  • Fax: 765-641-8238
Mailing address:
  • Phone: 765-649-8161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. C RICHARD DEHAVEN
Title or Position: VICE PRESIDENT & CEO
Credential:
Phone: 765-641-8281