Healthcare Provider Details

I. General information

NPI: 1740232115
Provider Name (Legal Business Name): CUMMINS BEHAVIORAL HEALTH SYSTEMS, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 E US HIGHWAY 36 STE 100
AVON IN
46123-6646
US

IV. Provider business mailing address

5101 E US HIGHWAY 36 STE 100
AVON IN
46123-6646
US

V. Phone/Fax

Practice location:
  • Phone: 888-714-1927
  • Fax: 317-745-9565
Mailing address:
  • Phone: 888-714-1927
  • Fax: 317-745-9565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateIN

VIII. Authorized Official

Name: AMY MACE
Title or Position: PRESIDENT & CEO
Credential: CPA, MBA
Phone: 888-714-1927