Provider Demographics
NPI:1255777090
Name:UNIVERSAL HEALTH AID
Entity type:Organization
Organization Name:UNIVERSAL HEALTH AID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF BOARD OF TRUSTEES
Authorized Official - Prefix:MR
Authorized Official - First Name:GAUTHAM
Authorized Official - Middle Name:VYAS MOHAN KRISHNA
Authorized Official - Last Name:MADHIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-480-9124
Mailing Address - Street 1:400 MAYNARD ST
Mailing Address - Street 2:APT 202
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2440
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 MAYNARD ST
Practice Address - Street 2:APT 202
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2440
Practice Address - Country:US
Practice Address - Phone:419-480-9124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health