Madison Center, Inc. | |
403 E Madison St South Bend IN 46617-2322 | |
(574) 234-0061 | |
(574) 283-1209 |
Full Name | Madison Center, Inc. |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 403 E Madison St, South Bend, Indiana |
Authorized Official Name and Position | Brenda J Clanton (CONTRACTS MANAGER) |
Authorized Official Contact | 5742831107 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Madison Center, Inc. 403 E Madison St South Bend IN 46617-2322 Ph: (574) 234-0061 | Madison Center, Inc. 403 E Madison St South Bend IN 46617-2322 Ph: (574) 234-0061 |
NPI Number | 1174671952 |
---|---|
Provider Enumeration Date | 01/08/2007 |
Last Update Date | 04/07/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174671952 | NPI | - | NPPES |
100451660A | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 406-14-PIP (Indiana) | Primary |
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