Infinity Treatment Centers Of America Llc | |
505 Nashua Rd Ste 8 Dracut MA 01826-1929 | |
(678) 296-0842 | |
(803) 932-9618 |
Full Name | Infinity Treatment Centers Of America Llc |
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Speciality | Clinic/Center |
Location | 505 Nashua Rd Ste 8, Dracut, Massachusetts |
Authorized Official Name and Position | Moinuddin H Muttakin (OWNER) |
Authorized Official Contact | 8032202238 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Infinity Treatment Centers Of America Llc 7655 Dunvegan Close Atlanta GA 30350-5502 Ph: (678) 296-0842 | Infinity Treatment Centers Of America Llc 505 Nashua Rd Ste 8 Dracut MA 01826-1929 Ph: (678) 296-0842 |
NPI Number | 1811650617 |
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Provider Enumeration Date | 10/19/2021 |
Last Update Date | 07/11/2023 |
Certification Date | 07/11/2023 |
Medicare PECOS PAC ID | 9436548021 |
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Medicare Enrollment ID | O20211122000562 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811650617 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Moinuddin H Muttakin |
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Provider Type | Practitioner - Geriatric Psychiatry |
Provider Identifiers | NPI Number: 1427158146 PECOS PAC ID: 4284674441 Enrollment ID: I20050506000212 |
Provider Name | Robin Mckinley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285971705 PECOS PAC ID: 1153566815 Enrollment ID: I20130328000466 |
Provider Name | Jobin Sebastian Kalathil |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023520749 PECOS PAC ID: 6709146509 Enrollment ID: I20190208001389 |
Provider Name | Chloe Fish |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366060832 PECOS PAC ID: 1355743477 Enrollment ID: I20210713000951 |
Provider Name | Sarah E Carew |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598393381 PECOS PAC ID: 7810399854 Enrollment ID: I20210713001766 |
Provider Name | Kristine C Buth |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770250193 PECOS PAC ID: 0244636421 Enrollment ID: I20210914001741 |
Provider Name | Jennifer Bedoya |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609447572 PECOS PAC ID: 0345635595 Enrollment ID: I20220324002498 |
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