NPI 1104974989

Madison Center, INC.

Organisation Psychiatric Residential Treatment Facility South Bend, IN

Practice location

Address: 403 E Madison St, South Bend, IN 46617-2322
Phone: (574) 231-0061
Fax: (574) 283-1209

Authorised official

Name: Brenda J Clanton
Title: Contracts Manager
Phone: (574) 283-1107

Registered specialties

Psychiatric Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 323P00000X Licence 406-1-PIP (IN)

Other Psychiatric Residential Treatment Facility providers in Indiana →

Registry record

NPI: 1104974989
Entity type: Organization
NPI issued: 8 Jan 2007
Record last updated: 7 Apr 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.