Provider Demographics
NPI:1538991443
Name:OAKLAWN PSYCHIATRIC CENTER, INC.
Entity type:Organization
Organization Name:OAKLAWN PSYCHIATRIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:574-214-5358
Mailing Address - Street 1:330 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46528-7000
Mailing Address - Country:US
Mailing Address - Phone:574-533-1234
Mailing Address - Fax:574-537-2652
Practice Address - Street 1:330 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46528-7000
Practice Address - Country:US
Practice Address - Phone:574-533-1234
Practice Address - Fax:574-537-2652
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:409-0-CMHC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100111390AMedicaid
IN100111390KMedicaid
IN300010045Medicaid
IN300016888Medicaid