| Backcountry Wellness Llc | |
|
7 Lincoln Avenue Greenwich CT 06830 | |
| (203) 992-1700 | |
| Not Available |
| Full Name | Backcountry Wellness Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 7 Lincoln Avenue, Greenwich, Connecticut |
| Authorized Official Name and Position | Joann S. Bronfman (OWNER/DIRECTOR) |
| Authorized Official Contact | 9147556472 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Backcountry Wellness Llc 7 Lincoln Avenue Greenwich CT 06830 Ph: (203) 992-1700 | Backcountry Wellness Llc 7 Lincoln Avenue Greenwich CT 06830 Ph: (203) 992-1700 |
| NPI Number | 1568959815 |
|---|---|
| Provider Enumeration Date | 04/21/2018 |
| Last Update Date | 03/04/2021 |
| Certification Date | 09/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568959815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CT006838 (Connecticut) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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