| NPI | 1073987053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SATISH DASARI CEO 219-513-9582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IN 16-013584-1) |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2016-05-17 |