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Organization
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC
Active
Organization
FAYETTE MEMORIAL HOSPITAL ASSOCIATION INC
Active
Other names
Fayette Regional Care Pavillion
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL WHITE (CEO)
(765) 827-7987
Entity
Organization
Contact information
Practice address
450 ERIE AVE, CONNERSVILLE, IN 47331-3176
(765) 827-7890
(765) 825-6628
Mailing address
1941 VIRGINIA AVE, CONNERSVILLE, IN 47331-2833
(765) 827-8933
(765) 827-7863
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
7352421900926
IN
Other
Enumeration date
03/18/2006
Last updated
03/23/2016
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