340B Drug Pricing Program Database
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FQHCLA361A Adult and Child Mental Health Center, Inc (Active)
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Main Details
Name
Adult and Child Mental Health Center, Inc
Subdivision Name
Adult and Child Heath - Northwood Plaza
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-021450
340B ID
FQHCLA361A
Grant Number
LALCS31537
Additional Details
Current Program Status
Active
Registration Date
2/1/2018
Participating Start Date
4/1/2018
Participating Approval Date
2/7/2018
Last Recertification Date
3/5/2025
Contacts
Authorizing Official
Adult and Child Health
Jessica Stembel, Chief Clinical Officer
(317) 494-0739
Primary Contact
Adult and Child Health
Dhvani Derasari, 340B Program Manager
(682) 559-8205
Addresses
Street Address
1860 Northwood Plaza
Franklin, IN 46131-1037
Billing Address
Adult and Child Health
8320 Madison Avenue
Adult and Child Health
Indianapolis, IN 46227
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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