Organization
GOOD SAMARITAN HOSPITAL
Active
Organization
GOOD SAMARITAN HOSPITAL
Active
Parent organization
GOOD SAMARITAN HOSPITAL
Other names
Samaritan Center - Waiver
Organization subpart
Yes
Provider details
NPI number
Legal business name
GOOD SAMARITAN HOSPITAL
Authorized official
JOHN MANNING (CHIEF OPERATING OFFICER)
(812) 885-2709
Entity
Organization
Contact information
Practice address
1901 WILLOW ST, VINCENNES, IN 47591-4277
(812) 885-2709
(812) 885-2729
Mailing address
515 BAYOU ST, VINCENNES, IN 47591-1034
(812) 886-6800
(812) 886-6809
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
IN
1041C0700X
Clinical Social Worker
—
IN
2084P0804X
Child & Adolescent Psychiatry Physician
—
IN
251S00000X
Community/Behavioral Health Agency
Primary
403-0-CMHC
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200898460A
—
IN
Enumeration date
02/11/2008
Last updated
08/05/2008
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