Organization
ANDERSON PSYCHIATRIC CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN E WENGER PHD (OWNER)
(765) 649-2234
Entity
Organization
Contact information
Practice address
431 WEST 9TH STREET, ANDERSON, IN 46016-1317
(765) 649-2234
(765) 640-0538
Mailing address
431 WEST 9TH STREET, ANDERSON, IN 46016-1317
(765) 649-2234
(765) 640-0538
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100170630A
—
IN
Enumeration date
11/08/2006
Last updated
05/16/2013
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