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Organization
INDIANA PSYCHIATRIC ASSOCIATES LLC
Active
Organization
INDIANA PSYCHIATRIC ASSOCIATES LLC
Active
Other names
QAM, QPM, Indiana TMS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SATYA KISHORE GUTTA MD (AUTHORIZED OFFICIAL)
(260) 208-9676
Entity
Organization
Contact information
Practice address
4656 W JEFFERSON BLVD STE 201, FORT WAYNE, IN 46804-6857
(978) 000-0001
Mailing address
4656 W JEFFERSON BLVD STE 201, FORT WAYNE, IN 46804-6857
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
09/28/2021
Last updated
02/18/2022
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