Provider Demographics
NPI:1629589387
Name:YUDAGURU LLC
Entity Type:Organization
Organization Name:YUDAGURU LLC
Other - Org Name:YUDAGURU INTEGRATIVE WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABHIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHA
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-720-0090
Mailing Address - Street 1:10176 BALTIMORE NATIONAL PIKE STE 110
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3651
Mailing Address - Country:US
Mailing Address - Phone:443-720-0090
Mailing Address - Fax:
Practice Address - Street 1:787 OELLA AVE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-4727
Practice Address - Country:US
Practice Address - Phone:443-720-0090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-20
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health