Provider Demographics
NPI:1154638088
Name:COMMUNITY MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:COMMUNITY MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF THERAPIST/CASE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:KINNE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:812-537-7382
Mailing Address - Street 1:611 SANTA CLARA VALLEY LN APT 8
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-5471
Mailing Address - Country:US
Mailing Address - Phone:812-537-7382
Mailing Address - Fax:
Practice Address - Street 1:611 SANTA CLARA VALLEY LN APT 8
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-5471
Practice Address - Country:US
Practice Address - Phone:812-537-7382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1000210251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management