Organization
GRANT-BLACKFORD MENTAL HEALTH, INC.
Active
Other names
Milestone Services
Organization subpart
No
Provider details
NPI number
Authorized official
LISA A. DOMINISSE (CEO)
(765) 668-6713
Entity
Organization
Contact information
Practice address
116 E 32ND ST, MARION, IN 46953-4060
(765) 662-2039
(765) 662-7480
Mailing address
505 N WABASH AVE, MARION, IN 46952-2608
(765) 662-3971
(765) 662-7480
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
414-0-CMHC
IN
Other
Enumeration date
01/29/2007
Last updated
09/08/2023
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