Provider Demographics
NPI:1598967309
Name:NEUROHEALTH LTD
Entity Type:Organization
Organization Name:NEUROHEALTH LTD
Other - Org Name:ALIVIO MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SALVADOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:YUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-635-3499
Mailing Address - Street 1:2060 N SHADELAND AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-1762
Mailing Address - Country:US
Mailing Address - Phone:317-635-3499
Mailing Address - Fax:317-635-0449
Practice Address - Street 1:2060 N SHADELAND AVE
Practice Address - Street 2:STE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-1762
Practice Address - Country:US
Practice Address - Phone:317-635-3499
Practice Address - Fax:317-635-0449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084N0400X, 208D00000X
IN01046966A2084N0400X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200240820Medicaid
ING99446Medicare UPIN
IN179630Medicare PIN