| Psychiatric Treatment & Resource Center Inc. | |
|
647 Main St East Haven CT 06512-2032 | |
| (203) 672-5956 | |
| (203) 404-7126 |
| Full Name | Psychiatric Treatment & Resource Center Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 647 Main St, East Haven, Connecticut |
| Authorized Official Name and Position | Linda Susan Grisgraber (APRN2035565225) |
| Authorized Official Contact | 2035565225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Treatment & Resource Center Inc. 310 Main St East Haven CT 06512-2919 Ph: (203) 672-5956 | Psychiatric Treatment & Resource Center Inc. 647 Main St East Haven CT 06512-2032 Ph: (203) 672-5956 |
| NPI Number | 1740587526 |
|---|---|
| Provider Enumeration Date | 02/14/2011 |
| Last Update Date | 10/05/2016 |
| Medicare PECOS PAC ID | 8921382482 |
|---|---|
| Medicare Enrollment ID | O20170228001854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740587526 | NPI | - | NPPES |
| 364SP0808X | Other | CT | CLINICAL SPECIALIST PSYCH MENTAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 001868 (Connecticut) | Primary |
| Provider Name | Linda S Grisgraber |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1922051135 PECOS PAC ID: 3274503206 Enrollment ID: I20040728000469 |
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