| Grant-blackford Mental Health, Inc. | |
|
118 E Washington St Hartford City IN 47348-2210 | |
| (765) 384-1303 | |
| (765) 662-7480 |
| Full Name | Grant-blackford Mental Health, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 118 E Washington St, Hartford City, Indiana |
| Authorized Official Name and Position | Lisa A. Dominisse (CEO) |
| Authorized Official Contact | 7656686713 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grant-blackford Mental Health, Inc. 505 N Wabash Ave Marion IN 46952-2608 Ph: (765) 662-3971 | Grant-blackford Mental Health, Inc. 118 E Washington St Hartford City IN 47348-2210 Ph: (765) 384-1303 |
| NPI Number | 1689710741 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 09/08/2023 |
| Certification Date | 09/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689710741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 414-0-CMHC (Indiana) | Primary |