NPI 1417968595

Bloomington Meadows Gp -

Organisation Psychiatric Residential Treatment Facility Bloomington, IN

Practice location

Address: 3600 N Prow Rd, Bloomington, IN 47404-1616
Phone: (812) 331-8000
Fax: (812) 331-8985

Authorised official

Name: Becky Nyberg
Title: Cfo
Phone: (812) 331-8000

Registered specialties

Psychiatric Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 323P00000X Licence 278652298 (IN)

Other Psychiatric Residential Treatment Facility providers in Indiana →

Registry record

NPI: 1417968595
Entity type: Organization
NPI issued: 11 Aug 2006
Record last updated: 31 Jan 2011

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.