Organization
MULBERRY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CARROLL (ACTING EXEC DIRECTOR)
(812) 436-4231
Entity
Organization
Contact information
Practice address
414 SE 4TH ST, EVANSVILLE, IN 47713-1206
(812) 423-4700
(812) 421-2618
Mailing address
414 SE 4TH ST, EVANSVILLE, IN 47713-1206
(812) 423-4700
(812) 421-2618
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200453230
—
IN
05
—
200453230A
—
IN
Enumeration date
12/18/2006
Last updated
04/01/2014
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