Organization
TRI-STATE BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANJUM SHEHZAD ASHRAF M.D (MEMBER)
(812) 962-2353
Entity
Organization
Contact information
Practice address
1116 MILLIS AVE, ST. MARY'S WARRICK, BOONVILLE, IN 47601
(812) 962-2353
(812) 962-0915
Mailing address
1900 WATERS RIDGE DR, NEWBURGH, IN 47630-8084
(812) 962-2353
(812) 962-0915
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01048619A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200478750 A
—
IN
01
—
234630
MEDICARE - ID
IN
Enumeration date
05/13/2008
Last updated
04/11/2013
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