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Organization
PISIPATI LLC
Active
Organization
PISIPATI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRABHAKAR PISIPATI M.D (OWNER)
(563) 219-0675
Entity
Organization
Contact information
Practice address
550 33RD AVE N, CLINTON, IA 52732-1585
(563) 242-0560
Mailing address
PO BOX 862, CLINTON, IA 52733-0862
(563) 219-0675
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
—
NULL
313M00000X
Nursing Facility/Intermediate Care Facility
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
12/16/2011
Last updated
12/16/2011
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