Organization
MADISON CENTER, INC.
Active
Parent organization
MADISON CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MADISON CENTER, INC.
Authorized official
BRENDA J CLANTON III (CONTRACTS MANAGER)
(574) 283-1107
Entity
Organization
Contact information
Practice address
403 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 234-0061
(574) 283-1209
Mailing address
403 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 234-0061
(574) 283-1209
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
406-14-PIP
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100451660A
—
IN
Enumeration date
01/08/2007
Last updated
04/07/2010
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