Organization
BUCK BLACK MENTAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BUCK J BLACK LCSW (PRESIDENT)
(765) 807-6778
Entity
Organization
Contact information
Practice address
100 SAW MILL RD STE 3102, LAFAYETTE, IN 47905-5598
(765) 807-6778
(765) 807-6778
Mailing address
100 SAW MILL RD STE 3102, LAFAYETTE, IN 47905-5598
(765) 807-6778
(765) 807-6778
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
34005584A
IN
Other
Enumeration date
10/08/2008
Last updated
08/06/2023
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