| NPI | 1871755264 |
|---|---|
| Former Legal Business Name | MIDWEST INSTITUTE FOR TREATMENT & STUDY OF ALCOHOLISM |
| Entity Type | Organization |
| Authorized Contact | GEORGE Y VENK Staff Psychiatrist VP 419-536-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: OH 35023979) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C00433) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35023979) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |