Organization
GOOD SAMARITAN HOSPITAL
Active
Parent organization
GOOD SAMARITAN HOSPITAL
Other names
Samaritan Center - Petersburg
Organization subpart
Yes
Provider details
NPI number
Legal business name
GOOD SAMARITAN HOSPITAL
Authorized official
MR. JOHN MANNING (VP BEHAVIORAL HEALTH/SPEC PROJECTS)
(812) 886-6800
Entity
Organization
Contact information
Practice address
611 E MAIN ST, SUITE 110, PETERSBURG, IN 47567-1267
(812) 354-8785
(812) 354-8786
Mailing address
515 BAYOU ST, VINCENNES, IN 47591-1034
(812) 886-6800
(812) 886-6809
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
4030
IN
101YA0400X
Addiction (Substance Use Disorder) Counselor
4030
IN
1041C0700X
Clinical Social Worker
4030
IN
2084P0800X
Psychiatry Physician
4030
IN
251S00000X
Community/Behavioral Health Agency
Primary
4030CMHC
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000574039
ANTHEM PIN FOR THIS LOCATION
IN
05
—
100270140C
—
IN
05
—
100270140G
—
IN
01
—
165526
MHN GROUP
IN
01
—
192466000
MAGELLAN
IN
01
—
301936
VALUE OPTIONS FACILITY
IN
Enumeration date
07/08/2005
Last updated
06/03/2015
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