Provider Demographics
NPI:1215242938
Name:MELEKA PSYCHIATRIC CARE, LLC
Entity type:Organization
Organization Name:MELEKA PSYCHIATRIC CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EVILINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MELEKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-880-0544
Mailing Address - Street 1:131 BAY ST FL 1
Mailing Address - Street 2:MELEKA PSYCHIATRIC CARE,LLC
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2521
Mailing Address - Country:US
Mailing Address - Phone:508-880-0544
Mailing Address - Fax:508-880-0545
Practice Address - Street 1:131 BAY ST FL 1
Practice Address - Street 2:MELEKA PSYCHIATRIC CARE,LLC
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2521
Practice Address - Country:US
Practice Address - Phone:508-880-0544
Practice Address - Fax:508-880-0545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA203803261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health