| Theraconnex Llc | |
|
138 Boylston St Brockton MA 02301-4142 | |
| (508) 596-6022 | |
| Not Available |
| Full Name | Theraconnex Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 138 Boylston St, Brockton, Massachusetts |
| Authorized Official Name and Position | Jalesa Janay Frye (OWNER) |
| Authorized Official Contact | 5085966022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theraconnex Llc 138 Boylston St Brockton MA 02301-4142 Ph: (508) 596-6022 | Theraconnex Llc 138 Boylston St Brockton MA 02301-4142 Ph: (508) 596-6022 |
| NPI Number | 1225612278 |
|---|---|
| Provider Enumeration Date | 05/06/2021 |
| Last Update Date | 05/06/2021 |
| Certification Date | 05/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225612278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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