Organization
GRANT-BLACKFORD MENTAL HEALTH, INC.
Active
Parent organization
GRANT-BALCKFORD MENTAL HEALTH, INC
Other names
RADIANT HEALTH SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANT-BALCKFORD MENTAL HEALTH, INC
Authorized official
LISA A. DOMINISSE (CEO)
(765) 668-6713
Entity
Organization
Contact information
Practice address
206 W 8TH ST, MARION, IN 46953-1921
(765) 664-7792
(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
01/26/2007
Last updated
09/08/2023
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