Organization Name: | PREMIER RECOVERY CENTER, LLC |
NPI Number: | 1255778502 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TRUPTI V PATEL (PRESIDENT) |
Mailing Address: | 4449 Easton Way Ste 200 Columbus |
State: | OH US |
Postal Code: | 432196093 |
Phone Number: | 6145476237 |
Fax Number: | |
NPI Enumeration Date: | 05/28/2013 |
NPI Last Update Date: | 05/28/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 35084995 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |