Provider Demographics
NPI:1588732747
Name:COMMUNITY MENTAL HEALTH CENTER INC.
Entity type:Organization
Organization Name:COMMUNITY MENTAL HEALTH CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TALBOT
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:812-537-1302
Mailing Address - Street 1:285 BIELBY RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-1055
Mailing Address - Country:US
Mailing Address - Phone:812-537-1302
Mailing Address - Fax:812-537-5219
Practice Address - Street 1:285 BIELBY RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1055
Practice Address - Country:US
Practice Address - Phone:812-537-1302
Practice Address - Fax:812-537-5219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN413-1-PIP283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100280850Medicaid
IN000000107432OtherBLUE CROSS PROVIDER NUMBE
IN100280850Medicaid
IN968950Medicare PIN
IN172150Medicare PIN
IN15-4011Medicare UPIN