| Wbc Connecticut East, Llc | |
|
2400 Tamarack Ave Suite 203 South Windsor CT 06074-5555 | |
| (860) 533-4672 | |
| (860) 533-4673 |
| Full Name | Wbc Connecticut East, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2400 Tamarack Ave, South Windsor, Connecticut |
| Authorized Official Name and Position | Stuart Koman (CEO / OWNER) |
| Authorized Official Contact | 7816476701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wbc Connecticut East, Llc 880 Main St Waltham MA 02451-8500 Ph: (781) 647-6767 | Wbc Connecticut East, Llc 2400 Tamarack Ave Suite 203 South Windsor CT 06074-5555 Ph: (860) 533-4672 |
| NPI Number | 1730442179 |
|---|---|
| Provider Enumeration Date | 06/20/2012 |
| Last Update Date | 10/04/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730442179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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