Amethyst House, Inc.
Substance Abuse Rehabilitation Facility in Bloomington, IN(View on Map)
Legal Business Name
Amethyst House, Inc.
NPI Number
1770709230
NPI Type
Organization
Enumeration Date
04/17/2007
Specialties
(Taxonomies)Code
324500000X
251S00000X
Primary Taxonomy
Yes
No
Licenses
State
Indiana
Indiana
License Number
1279-0 CA
1279-0 ASR
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 11
645 N WALNUT ST
City
Bloomington
Bloomington
State
IN
IN
Postal Code
47402-0011
47404-3846
Country
US
US
Telephone Number
(812) 336-3570
(812) 336-3570
Authorized Official
Name
Mark Delong
Title or Position
EXECUTIVE DIRECTOR
Telephone Number
(812) 336-3570
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/26/2011
Provider Address
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Centerstone Of Indiana, Inc.
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