Provider Demographics
NPI:1386485233
Name:PHEBUS BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:PHEBUS BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:REANN
Authorized Official - Last Name:PHEBUS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:765-418-7477
Mailing Address - Street 1:5695 E VALLEYVIEW PT
Mailing Address - Street 2:
Mailing Address - City:BRINGHURST
Mailing Address - State:IN
Mailing Address - Zip Code:46913-9441
Mailing Address - Country:US
Mailing Address - Phone:765-418-7477
Mailing Address - Fax:
Practice Address - Street 1:3601 SAGAMORE PKWY N STE G
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-5033
Practice Address - Country:US
Practice Address - Phone:765-232-3503
Practice Address - Fax:765-544-3740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center