Provider Demographics
NPI:1255011847
Name:RAMHARACK ADDICTION LLC
Entity type:Organization
Organization Name:RAMHARACK ADDICTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMHARACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-415-4427
Mailing Address - Street 1:3095 BLAKE ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2347
Mailing Address - Country:US
Mailing Address - Phone:347-415-4427
Mailing Address - Fax:
Practice Address - Street 1:3095 BLAKE ST UNIT 2
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2347
Practice Address - Country:US
Practice Address - Phone:347-415-4427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-19
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty