Westside Mental Health
LBN: Mental Wellness Inc
Westside Mental Health is an health care organization with primary practice located at 192 N Avon Ave Suite 300, Avon IN 46123-9513. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as the primary health care specialty.
Mental Wellness Inc can be contacted via phone (317) 672-6400, or through Bradford, Tammy Jo Coomer via phone (507) 779-4795.
Contact Information
Primary practice address
192 N Avon Ave Suite 300
Avon IN 46123-9513
Phone: (317) 672-6400
Fax: (317) 672-6401
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 364SP0808X | 70000195A | Indiana |
Profile Details
| NPI number | 1811358492 |
|---|---|
| LBN Legal business name | Mental Wellness Inc |
| DBA Doing business as | Westside Mental Health |
| Authorized official | Bradford, Tammy Jo Coomer CNS, APRN-BC |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 10th, 2016 |
| Last updated | Apr 1st, 2016 - about 8 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811358492 | NPPES |
| Other | 1730265356 | PROVIDER NPI | |
| MEDICAID | 200285820 | PROVIDER NPI |
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