| Organization Name: | FOUR COUNTY COMPREHENSIVE MENTAL HEALTH |
| NPI Number: | 1053387803 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LARRY ULRICH (CEO) |
| Mailing Address: | 1015 Michigan Ave Main Center Logansport |
| State: | IN US |
| Postal Code: | 469471526 |
| Phone Number: | 5747225151 |
| Fax Number: | 5747391414 |
| NPI Enumeration Date: | 02/23/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 427-1-PIP |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |