Organization
CATHOLIC CHARITIES
Active
Other names
Cathlic Charities Bloomington
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID J. BETHURAM (EXECUTIVE DIRECTOR)
(317) 236-1500
Entity
Organization
Contact information
Practice address
803 N MONROE ST, BLOOMINGTON, IN 47404-3321
(812) 332-1262
(812) 334-8464
Mailing address
803 N MONROE ST, BLOOMINGTON, IN 47404-3321
(812) 332-1262
(812) 334-8464
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000 189106
ANTHEM PROVIDER
IN
05
—
100121560A
—
IN
01
—
703415000
MAGELLAN PROVIDER
IN
Enumeration date
09/20/2006
Last updated
07/22/2016
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