Healthcare Provider Details

I. General information

NPI: 1639172810
Provider Name (Legal Business Name): BOWEN HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 N HARRISON ST
WARSAW IN
46580-3163
US

IV. Provider business mailing address

2621 E JEFFERSON ST
WARSAW IN
46580-3880
US

V. Phone/Fax

Practice location:
  • Phone: 574-267-7169
  • Fax: 574-269-3995
Mailing address:
  • Phone: 574-267-7169
  • Fax: 574-269-3995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number4230CMHC
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number4231PIP
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number4230CMHC
License Number StateIN

VIII. Authorized Official

Name: MR. JAY M BAUMGARTNER
Title or Position: SR VP FISCAL DIVISION
Credential:
Phone: 574-267-7169