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Organization
COMMUNITY HOSPITAL OF IN, INC
Active
Organization
COMMUNITY HOSPITAL OF IN, INC
Active
Parent organization
COMMUNITY HOSPITAL OF IN
Other names
Gallahue Mental Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY HOSPITAL OF IN
Authorized official
ANTHONY JAVORKA COO (AUTHORIZED OFFICIAL)
(317) 621-1591
Entity
Organization
Contact information
Practice address
6626 E 75TH STREET, STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7561
(317) 355-6096
Mailing address
6626 E 75TH STREET, STE 500, INDIANAPOLIS, IN 46250
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
416
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270530B
—
IN
Enumeration date
06/18/2008
Last updated
04/05/2017
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