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Organization
STATE OF INDIANA, AUDITOR OF STATE
Active
Organization
STATE OF INDIANA, AUDITOR OF STATE
Active
Other names
MADISON STATE HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PEGGY S STEPHENS MD (SUPERINTENDANT AND MEDICAL DIRECTOR)
(812) 265-2611
Entity
Organization
Contact information
Practice address
711 GREEN RD, MADISON, IN 47250-2143
(812) 265-2611
(812) 265-7225
Mailing address
711 GREEN RD, MADISON, IN 47250-2143
(812) 265-2611
(812) 265-7225
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
03/22/2007
Last updated
02/01/2008
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