N/a | |
185 Fabyan Rd North Grosvenordale CT 06255-1506 | |
(860) 315-0565 | |
(860) 315-0565 |
Full Name | N/a |
---|---|
Speciality | Community/behavioral Health |
Location | 185 Fabyan Rd, North Grosvenordale, Connecticut |
Authorized Official Name and Position | Michael Weinberg (MANAGER) |
Authorized Official Contact | 8603150565 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
N/a 185 Fabyan Rd North Grosvenordale CT 06255-1506 Ph: (860) 315-0565 | N/a 185 Fabyan Rd North Grosvenordale CT 06255-1506 Ph: (860) 315-0565 |
NPI Number | 1811387012 |
---|---|
Provider Enumeration Date | 01/27/2015 |
Last Update Date | 01/27/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811387012 | NPI | - | NPPES |
1851572598 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 002562 (Connecticut) | Primary |
Melissa Gobin, Licsw, Lcsw Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 64 Gaumond Rd, North Grosvenordale, CT 06255 Phone: 860-377-8995 |