| Valle Vista Guidance Center Pc | |
|
896 E Main St 4 Greenwood IN 46143-1440 | |
| (317) 887-2121 | |
| (317) 887-5731 |
| Full Name | Valle Vista Guidance Center Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 896 E Main St, Greenwood, Indiana |
| Authorized Official Name and Position | Shaku V Patel (OFFICE MANAGER) |
| Authorized Official Contact | 3178872121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valle Vista Guidance Center Pc 896 E Main St 4 Greenwood IN 46143-1440 Ph: (317) 887-2121 | Valle Vista Guidance Center Pc 896 E Main St 4 Greenwood IN 46143-1440 Ph: (317) 887-2121 |
| NPI Number | 1447277421 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0042278186 |
|---|---|
| Medicare Enrollment ID | O20041221000745 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447277421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Sajal K Bose |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932126901 PECOS PAC ID: 4981660958 Enrollment ID: I20041202000259 |
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