| NPI | 1821961855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KUMAR RAMDAS Admin 862-400-2558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2025-09-25 |
| Last Update Date | 2025-10-13 |