15D2036055 CLIA NUMBER - DOCTORS BEHAVIORAL HOSPITAL, LLC

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Laboratory Demographics

CLIA Number: 15D2036055

Facility Name: DOCTORS BEHAVIORAL HOSPITAL, LLC

Facility Address:
417 S WHITLOCK ST
BREMEN, IN
ZIP 46506
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Facility Phone Number: 574 546-0330

Facility Type: Hospital

Certificate Type: Waiver

NPI Number: 1700172970

Taxonomy: 283Q00000X - Psychiatric Hospital
An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.

CLIA Record

Field Name	Field Value
CLIA Number	15D2036055
LAB Type	Hospital
Facility Name	DOCTORS BEHAVIORAL HOSPITAL, LLC
Street	417 S WHITLOCK ST
City	BREMEN
State	IN
ZIP	46506
Phone	574 546-0330
CertificateType	4
CertificateEffectiveDate	1/31/2024
CertificateExpirationDate	1/30/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024