Provider Demographics
NPI:1558679944
Name:CUMMINS BEHAVIORAL HEALTH SYSTEM
Entity Type:Organization
Organization Name:CUMMINS BEHAVIORAL HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BORDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-272-3330
Mailing Address - Street 1:5101 E US HIGHWAY 36
Mailing Address - Street 2:STE 100
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-6645
Mailing Address - Country:US
Mailing Address - Phone:317-745-9555
Mailing Address - Fax:317-745-9565
Practice Address - Street 1:6655 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-8923
Practice Address - Country:US
Practice Address - Phone:317-272-3330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100133060Medicaid
IN200097010Medicaid
IN100133060Medicaid