| Full Circle Youth Empowerment | |
|
583-585 East Main Street Bridgeport CT 06608 | |
| (203) 332-6200 | |
| (203) 332-6202 |
| Full Name | Full Circle Youth Empowerment |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 583-585 East Main Street, Bridgeport, Connecticut |
| Authorized Official Name and Position | Andrea Andrews (CREDENTIALING MANAGER) |
| Authorized Official Contact | 2034002725 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Circle Youth Empowerment 2310 Madison Ave Bridgeport CT 06606-3241 Ph: (203) 400-2725 | Full Circle Youth Empowerment 583-585 East Main Street Bridgeport CT 06608 Ph: (203) 332-6200 |
| NPI Number | 1184193591 |
|---|---|
| Provider Enumeration Date | 11/14/2018 |
| Last Update Date | 11/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184193591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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