Organization
CLINICAL FAMILY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY LEE GRAY LCSW (PRESIDENT)
(317) 919-0093
Entity
Organization
Contact information
Practice address
1404 KIMMELL ROAD, VINCENNES, IN 47591
(317) 919-0093
Mailing address
1404 KIMMELL ROAD, VINCENNES, IN 47591
(317) 919-0093
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100133060
—
IN
Enumeration date
01/25/2023
Last updated
01/25/2023
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