| Make Over 2710 Inc | |
|
60 Westwood Ave # 315 Waterbury CT 06708-2460 | |
| (203) 519-0503 | |
| Not Available |
| Full Name | Make Over 2710 Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 60 Westwood Ave # 315, Waterbury, Connecticut |
| Authorized Official Name and Position | Terrell Pitts (COFOUNDER) |
| Authorized Official Contact | 2035190503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Make Over 2710 Inc 80 Sprucedale Dr Waterbury CT 06706-2838 Ph: (203) 519-0503 | Make Over 2710 Inc 60 Westwood Ave # 315 Waterbury CT 06708-2460 Ph: (203) 519-0503 |
| NPI Number | 1114747904 |
|---|---|
| Provider Enumeration Date | 10/15/2024 |
| Last Update Date | 10/25/2024 |
| Certification Date | 10/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114747904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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