Provider Demographics
NPI:1699358390
Name:IMPERIAL HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:IMPERIAL HEALTHCARE SERVICES LLC
Other - Org Name:SUBSTANCE IOT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NJEI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:302-724-1181
Mailing Address - Street 1:601 E NAYLOR MILL RD UNIT F
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-2256
Mailing Address - Country:US
Mailing Address - Phone:410-572-4738
Mailing Address - Fax:410-572-4649
Practice Address - Street 1:601 E NAYLOR MILL RD UNIT F
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-2256
Practice Address - Country:US
Practice Address - Phone:410-572-4738
Practice Address - Fax:410-572-4649
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IMPERIAL HEALTHCARE SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-30
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder