DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: GRANT-BLACKFORD MENTAL HEALTH, INC.

MEDICARE: GRANT-BLACKFORD MENTAL HEALTH, INC.
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
1251S00000XCommunity/Behavioral Health Agency414-0-CMHCIN

General Provider Information

NPI Number : 1689710741
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRANT-BLACKFORD MENTAL HEALTH, INC.
Provider Business Mailing Address
First Line : 505 N WABASH AVE
Second Line :
City : MARION
State : IN
Zip : 46952-2608
Country : US
Telephone Number : 765-662-3971
Fax Number : 765-662-7480
Provider Business Practice Location Address
First Line : 118 E WASHINGTON ST
Second Line :
City : HARTFORD CITY
State : IN
Zip : 47348-2210
Country : US
Telephone Number : 765-384-1303
Fax Number : 765-662-7480
Authorized Official
Title or Position : CEO
Name : LISA A. DOMINISSE
Credential :
Telephone Number : 765-668-6713
Provider Enumeration Date : 01/29/2007
Last Update Date : 09/08/2023

Similar Medicare Providers

1609813682 — REBECCA KOVACS LCSW
Practice Location Address:
118 E WASHINGTON ST
HARTFORD CITY, IN
47348-2210
Practice Phone: 765-348-1303
Practice Fax:
1467156455 — SARAH HOWARD
Practice Location Address:
118 E WASHINGTON ST
HARTFORD CITY, IN
47348-2210
Practice Phone: 765-662-3971
Practice Fax:
1184494346 — ANGELA D HUMPHREY LMHC
Practice Location Address:
118 E WASHINGTON ST
HARTFORD CITY, IN
47348-2210
Practice Phone: 765-348-1303
Practice Fax:
1447981659 — JEFFREY GEORGE PHARMD
Practice Location Address:
68 BREWSTER RD
WEST HARTFORD, CT
06117-2210
Practice Phone: 860-256-9589
Practice Fax:
1902999808 — DR. ROGER L FRAZIER DO
Practice Location Address:
2008 NO WALNUT ST
HARTFORD CITY, IN
47348
Practice Phone: 765-348-0902
Practice Fax: 765-348-7276
1699622183 — FELICITY MAE NEW APRN, FNP-C
Practice Location Address:
2008 N WALNUT ST
HARTFORD CITY, IN
47348-1364
Practice Phone: 765-329-6662
Practice Fax: 765-329-6663

Directions to “GRANT-BLACKFORD MENTAL HEALTH, INC. ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.