Organization
STATE OF INDIANA AUDITOR OF STATE
Active
Other names
Evansville State Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
CATHE FULCHER (SUPERINTENDENT)
(812) 469-6800
Entity
Organization
Contact information
Practice address
3400 LINCOLN AVENUE, EVANSVILLE, IN 47714
(812) 469-6800
(812) 469-6847
Mailing address
3400 LINCOLN AVENUE, EVANSVILLE, IN 47714
(812) 469-6800
(812) 469-6847
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100272090
—
IN
Enumeration date
04/03/2007
Last updated
08/30/2010
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