Organization
GOOD SAMARITAN HOSPITAL
Active
Organization
GOOD SAMARITAN HOSPITAL
Active
Parent organization
GOOD SAMARITAN HOSPITAL
Other names
Samaritan Center - LaSalle Behavioral Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
GOOD SAMARITAN HOSPITAL
Authorized official
ANGELA BOTTOMS II C.P.A. (DIRECTOR FINANCIAL SERVICES)
(812) 885-2709
Entity
Organization
Contact information
Practice address
520 S 7TH ST, VINCENNES, IN 47591-1038
(812) 886-6800
(812) 886-6809
Mailing address
515 BAYOU ST, VINCENNES, IN 47591-1034
(812) 886-6800
(812) 886-6809
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
05-005038-1
IN
2084P0800X
Psychiatry Physician
403-0
IN
273R00000X
Psychiatric Hospital Unit
Primary
05-005038-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000574014
ANTHEM PIN FOR THIS LOCATION
IN
01
—
039738000
MAGELLAN
IN
05
—
100270140
—
IN
01
—
301936
VALUE OPTIONS FACILITY
IN
Enumeration date
07/12/2005
Last updated
02/24/2011
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