| Child And Family Agency Of Southeastern Connecticut, Inc. | |
|
591 Poquonnock Rd Groton CT 06340-4571 | |
| (860) 449-8217 | |
| (860) 449-8323 |
| Full Name | Child And Family Agency Of Southeastern Connecticut, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 591 Poquonnock Rd, Groton, Connecticut |
| Authorized Official Name and Position | Lisa Baxter (CHIEF FINANCIAL AND ADMIN OFFICER) |
| Authorized Official Contact | 8604432896 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child And Family Agency Of Southeastern Connecticut, Inc. 255 Hempstead St New London CT 06320-6204 Ph: () - | Child And Family Agency Of Southeastern Connecticut, Inc. 591 Poquonnock Rd Groton CT 06340-4571 Ph: (860) 449-8217 |
| NPI Number | 1932240504 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 06/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932240504 | NPI | - | NPPES |
| 007228736 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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