Organization
FAMILY AND CHILDREN'S PLACE
Active
Organization
FAMILY AND CHILDREN'S PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MCKENZIE BETH SMITH M.F.T. (FAMILY PRESERVATION THERAPIST)
(812) 944-6120
Entity
Organization
Contact information
Practice address
2818 GRANT LINE RD, NEW ALBANY, IN 47150-2492
(812) 944-6120
(812) 941-5726
Mailing address
2818 GRANT LINE RD, NEW ALBANY, IN 47150-2492
(812) 944-6120
(812) 941-5726
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NA
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100415400
—
IN
Enumeration date
01/29/2010
Last updated
01/29/2010
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