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General NPI Number Information
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NPI Number | 1023069440
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH INSTITUTE
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 2277 IOWA AVE
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City | INDEPENDENCE
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State | IA
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Zip | 50644-9106
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Country | US
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Telephone | 319-334-2583
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Fax | 319-334-5252
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Provider Business Mailing Address
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Address Line | 2277 IOWA AVE
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City | INDEPENDENCE
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State | IA
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Zip | 50644-9106
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Country | US
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Telephone | 319-334-2583
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Fax | 319-334-5252
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Authorized Official
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Title or Position | SUPERINTENDANT
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Name | DR. BHASKER DAVE
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Credential | M.D.
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Telephone | 319-334-2583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 100068H
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License Number State | IA
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