Organization
CENTERSTONE OF INDIANA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE L KOESEL LCSW (CEO)
(812) 337-2350
Entity
Organization
Contact information
Practice address
645 S ROGERS ST, BLOOMINGTON, IN 47403
(812) 339-1691
(812) 337-2438
Mailing address
645 S ROGERS STREET, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 337-2438
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
431-049
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100182650
—
IN
Enumeration date
12/16/2005
Last updated
08/28/2024
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