Amethyst House, Inc. | |
645 N Walnut St Bloomington IN 47404-3846 | |
(812) 336-3570 | |
(812) 336-9010 |
Full Name | Amethyst House, Inc. |
---|---|
Speciality | Substance Abuse Rehabilitation Facility |
Location | 645 N Walnut St, Bloomington, Indiana |
Authorized Official Name and Position | Mark Delong (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8123363570 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Amethyst House, Inc. Po Box 11 Bloomington IN 47402-0011 Ph: (812) 336-3570 | Amethyst House, Inc. 645 N Walnut St Bloomington IN 47404-3846 Ph: (812) 336-3570 |
NPI Number | 1770709230 |
---|---|
Provider Enumeration Date | 04/17/2007 |
Last Update Date | 09/26/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770709230 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 1279-0 ASR (Indiana) | Secondary |
324500000X | Substance Abuse Rehabilitation Facility | 1279-0 CA (Indiana) | Primary |
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