Organization
FOUR COUNTY COMPREHENSIVE MENTAL HEALTH
Active
Other names
Four County Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY ULRICH (CEO)
(574) 722-5151
Entity
Organization
Contact information
Practice address
1015 MICHIGAN AVE, LOGANSPORT, IN 46947-1526
(574) 722-5151
(574) 722-9523
Mailing address
1015 MICHIGAN AVE, LOGANSPORT, IN 46947-1526
(574) 722-5151
(574) 722-9523
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28145473A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28145473A
IN LICENSE
IN
Enumeration date
11/09/2006
Last updated
08/22/2020
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