Healthcare Provider Details

I. General information

NPI: 1114296506
Provider Name (Legal Business Name): SANTON MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2011
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4265 E MAIN ST
AVON IN
46123-9174
US

IV. Provider business mailing address

4265 E MAIN ST
AVON IN
46123-9174
US

V. Phone/Fax

Practice location:
  • Phone: 317-268-5555
  • Fax: 317-268-6556
Mailing address:
  • Phone: 317-268-6555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHY SANTON
Title or Position: PRESIDENT
Credential: APRN, MSN, CNS
Phone: 765-744-4443