NPI | 1396456943 |
---|---|
Entity Type | Organization |
Authorized Contact | RAMESH BABU VEMURI Owner 815-444-9999 |
Organization Subpart ? | No |
Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
Enumeration Date | 2022-12-05 |
Last Update Date | 2022-12-20 |