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Organization
INDIANA CENTER FOR RECOVERY OUTPATIENT SERVICES LLC
Active
Organization
INDIANA CENTER FOR RECOVERY OUTPATIENT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRILL VESSELOV (PRESIDENT)
(561) 305-0461
Entity
Organization
Contact information
Practice address
1578 E 85TH AVE, MERRILLVILLE, IN 46410-8900
(561) 305-0461
Mailing address
2925 10TH AVE N, PALM SPRINGS, FL 33461-3000
(561) 305-0461
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
02/13/2023
Last updated
12/14/2023
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