Familywise Behavior Solutions | |
4 Broadway Avenue Ext 2c Mystic CT 06355-2850 | |
(860) 642-7379 | |
Not Available |
Full Name | Familywise Behavior Solutions |
---|---|
Speciality | Community/behavioral Health |
Location | 4 Broadway Avenue Ext, Mystic, Connecticut |
Authorized Official Name and Position | Cynthia W West (OWNER) |
Authorized Official Contact | 8606427379 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Familywise Behavior Solutions Po Box 26 Mystic CT 06355-0026 Ph: () - | Familywise Behavior Solutions 4 Broadway Avenue Ext 2c Mystic CT 06355-2850 Ph: (860) 642-7379 |
NPI Number | 1659826048 |
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Provider Enumeration Date | 08/16/2016 |
Last Update Date | 08/16/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659826048 | NPI | - | NPPES |
204714 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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