| Grace Valley Clinical Services | |
|
27 Holmes Dr Windsor CT 06095-3969 | |
| (806) 905-4776 | |
| Not Available |
| Full Name | Grace Valley Clinical Services |
|---|---|
| Speciality | Counselor - Professional |
| Location | 27 Holmes Dr, Windsor, Connecticut |
| Authorized Official Name and Position | Krystal Kelly (CEO) |
| Authorized Official Contact | 8609054776 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Valley Clinical Services Po Box 186 Windsor CT 06095-0186 Ph: (860) 905-4776 | Grace Valley Clinical Services 27 Holmes Dr Windsor CT 06095-3969 Ph: (806) 905-4776 |
| NPI Number | 1841926045 |
|---|---|
| Provider Enumeration Date | 07/29/2022 |
| Last Update Date | 08/11/2022 |
| Certification Date | 08/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841926045 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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