Organization
CHILDPLACE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN G. DAVIS (PROGRAM SUPERVISOR)
(812) 282-8248
Entity
Organization
Contact information
Practice address
2420 E 10TH ST, JEFFERSONVILLE, IN 47130-7303
(812) 282-8248
(812) 282-3291
Mailing address
2420 E 10TH ST, JEFFERSONVILLE, IN 47130-7303
(812) 282-8248
(812) 282-3291
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
33428 10-900845
IN
Other
Enumeration date
04/04/2007
Last updated
08/22/2020
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