Provider Demographics
NPI:1205155512
Name:IN-HOUSE GERIATRIC CARE P.C.
Entity type:Organization
Organization Name:IN-HOUSE GERIATRIC CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SRIDEVI
Authorized Official - Middle Name:
Authorized Official - Last Name:YALALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:248-269-3412
Mailing Address - Street 1:1985 W BIG BEAVER RD STE 310
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3409
Mailing Address - Country:US
Mailing Address - Phone:248-269-3412
Mailing Address - Fax:
Practice Address - Street 1:1985 W BIG BEAVER RD STE 310
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3409
Practice Address - Country:US
Practice Address - Phone:248-269-3412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-26
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
313M00000X
MI4301064391208M00000X, 207R00000X
MI207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care FacilityGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty