Cleanslate Medical Group Of Connecticut Llc | |
85 Gillett St Hartford CT 06105-2630 | |
(615) 425-0220 | |
(413) 727-3619 |
Full Name | Cleanslate Medical Group Of Connecticut Llc |
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Speciality | Internal Medicine - Addiction Medicine |
Location | 85 Gillett St, Hartford, Connecticut |
Authorized Official Name and Position | Robert Hutchison (CFO) |
Authorized Official Contact | 6154250220 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Cleanslate Medical Group Of Connecticut Llc 8 Cadillac Dr Ste 180 Brentwood TN 37027-5393 Ph: (615) 425-0220 | Cleanslate Medical Group Of Connecticut Llc 85 Gillett St Hartford CT 06105-2630 Ph: (615) 425-0220 |
NPI Number | 1073057071 |
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Provider Enumeration Date | 12/09/2016 |
Last Update Date | 03/23/2023 |
Identifier | Type | State | Issuer |
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1073057071 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Primary |
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