Organization
STATE OF INDIANA - AUDITOR OF STATE
Active
Organization
STATE OF INDIANA - AUDITOR OF STATE
Active
Parent organization
INDIANA STATE FAMILY & SOCIAL SERVICE ADM
Other names
RICHMOND STATE HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDIANA STATE FAMILY & SOCIAL SERVICE ADM
Authorized official
DAVID M SHELFORD (ASSISTANT SUPERINTENDENT)
(765) 935-9206
Entity
Organization
Contact information
Practice address
498 NW 18TH ST, RICHMOND, IN 47374-2851
(765) 966-0511
(765) 935-9503
Mailing address
498 NW 18TH ST, RICHMOND, IN 47374-2851
(765) 966-0511
(765) 935-9507
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100256720A
—
IN
Enumeration date
04/23/2007
Last updated
05/05/2014
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