Provider Demographics
NPI:1225601826
Name:AUTUMN TREATMENT CENTER LLC
Entity Type:Organization
Organization Name:AUTUMN TREATMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MADHUKAR
Authorized Official - Middle Name:
Authorized Official - Last Name:NARAHARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-599-3800
Mailing Address - Street 1:485 METRO PL S STE 101
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-5374
Mailing Address - Country:US
Mailing Address - Phone:614-599-3800
Mailing Address - Fax:
Practice Address - Street 1:24865 US HIGHWAY 23 S STE A
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-9189
Practice Address - Country:US
Practice Address - Phone:614-219-9394
Practice Address - Fax:866-421-8583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder