| NPI | 1437719846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMESH BABU VEMURI Owner 815-444-9999 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2022-12-20 |