Provider Demographics
NPI:1720329113
Name:CAROCIBA INC
Entity Type:Organization
Organization Name:CAROCIBA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:OBATUSIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-324-0515
Mailing Address - Street 1:710 S 13TH ST
Mailing Address - Street 2:STE 900
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5792
Mailing Address - Country:US
Mailing Address - Phone:404-324-0515
Mailing Address - Fax:402-844-4114
Practice Address - Street 1:710 S 13TH ST
Practice Address - Street 2:STE 900
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5792
Practice Address - Country:US
Practice Address - Phone:404-324-0515
Practice Address - Fax:402-844-4114
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROCIBA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-08
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty