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Organization
STATE OF INDIANA AUDITOR OF STATE
Active
Organization
STATE OF INDIANA AUDITOR OF STATE
Active
Other names
Evansville State Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
CATHE FULCHER (SUPERINTENDENT)
(812) 469-6800
Entity
Organization
Contact information
Practice address
3400 LINCOLN AVENUE, EVANSVILLE, IN 47714
(812) 469-6800
(812) 469-6847
Mailing address
3400 LINCOLN AVENUE, EVANSVILLE, IN 47714
(812) 469-6800
(812) 469-6847
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100272090
—
IN
Enumeration date
04/03/2007
Last updated
08/30/2010
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