Organization
GOOD SAMARITAN HOSPITAL
Active
Parent organization
GOOD SAMARITAN HOSPITAL
Other names
Samaritan Center-Buntin
Organization subpart
Yes
Provider details
NPI number
Legal business name
GOOD SAMARITAN HOSPITAL
Authorized official
JOHN MANNING (VP BEHAVIORAL HEALTH/SPEC PROJECTS)
(812) 886-6800
Entity
Organization
Contact information
Practice address
121 BUNTIN ST, VINCENNES, IN 47591-1320
(812) 885-2700
(812) 885-2716
Mailing address
515 BAYOU ST, VINCENNES, IN 47591-1034
(812) 886-6800
(812) 886-6809
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4030
IN
104100000X
Social Worker
4030
IN
1041C0700X
Clinical Social Worker
4030
IN
251S00000X
Community/Behavioral Health Agency
Primary
4030CMHC
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000574042
ANTHEM PIN FOR THIS LOCATION
IN
05
—
100270140G
—
IN
05
—
100270140M
—
IN
01
—
165526
MHN GROUP
IN
01
—
326003
VALUE OPTIONS
IN
Enumeration date
07/08/2005
Last updated
04/24/2014
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