Organization
IMEX INC
Active
Other names
KTA MAT & Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN TRANGLE MD, MBA (OWNER)
(216) 504-0400
Entity
Organization
Contact information
Practice address
8251 MAYFIELD RD STE 105, CHESTERLAND, OH 44026
(216) 504-0400
Mailing address
6150 PARKLAND BLVD STE 110, MAYFIELD HEIGHTS, OH 44124-4103
(216) 504-0400
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
2083X0100X
Occupational Medicine Physician
Primary
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0277816
—
OH
05
—
055028
—
OH
Enumeration date
03/21/2018
Last updated
12/05/2018
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