Provider Demographics
NPI:1801437785
Name:OPEN DOOR TREATMENT CENTER INC
Entity type:Organization
Organization Name:OPEN DOOR TREATMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ONDACHI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:919-607-6485
Mailing Address - Street 1:3622 MERRITT ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-3734
Mailing Address - Country:US
Mailing Address - Phone:919-607-6485
Mailing Address - Fax:
Practice Address - Street 1:3622 MERRITT ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-3734
Practice Address - Country:US
Practice Address - Phone:919-607-6485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)