Provider Demographics
NPI:1891820817
Name:FRANCISCAN ST FRANCIS
Entity Type:Organization
Organization Name:FRANCISCAN ST FRANCIS
Other - Org Name:FRANCISCAN ST FRANCIS HEALTH BEHAVIORAL HEALTH OFFICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-528-8260
Mailing Address - Street 1:1040 SIERRA DRIVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7241
Mailing Address - Country:US
Mailing Address - Phone:317-528-4254
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:610 E SOUTHPORT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-8592
Practice Address - Country:US
Practice Address - Phone:317-783-8383
Practice Address - Fax:317-782-6929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200023750AMedicaid
IN100057420BMedicaid
IN092580Medicare ID - Type Unspecified