| Coastal Green Healing, Pllc | |
|
30 Old Kings Highway South 1st Floor Ste 202 Darien CT 06820-4551 | |
| (877) 692-6772 | |
| (204) 904-2446 |
| Full Name | Coastal Green Healing, Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 30 Old Kings Highway South, Darien, Connecticut |
| Authorized Official Name and Position | Megan Mary Kelly Gilman (OWNER) |
| Authorized Official Contact | 2036412530 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Green Healing, Pllc 1204 Main St # 925 Branford CT 06405-3787 Ph: (203) 444-3076 | Coastal Green Healing, Pllc 30 Old Kings Highway South 1st Floor Ste 202 Darien CT 06820-4551 Ph: (877) 692-6772 |
| NPI Number | 1922683721 |
|---|---|
| Provider Enumeration Date | 03/12/2021 |
| Last Update Date | 03/12/2021 |
| Certification Date | 03/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922683721 | NPI | - | NPPES |
| 312631 | Other | CT | ATN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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