| Community Child Guidance Clinic, Inc. | |
|
317 N Main St Manchester CT 06042-2007 | |
| (860) 643-2101 | |
| (860) 645-1470 |
| Full Name | Community Child Guidance Clinic, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 317 N Main St, Manchester, Connecticut |
| Authorized Official Name and Position | Clifford Johnson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8606432101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Child Guidance Clinic, Inc. 317 N Main St Manchester CT 06042-2007 Ph: (860) 643-2101 | Community Child Guidance Clinic, Inc. 317 N Main St Manchester CT 06042-2007 Ph: (860) 643-2101 |
| NPI Number | 1780730267 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 05/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780730267 | NPI | - | NPPES |
| 004039277 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 0238 (Connecticut) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | OPCC-14 (Connecticut) | Primary |
Vernon Manor Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 385 W Center St, Manchester, CT 06040 Phone: 860-871-0385 | |
Jeffrey H. Katz, M.d., L.l.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 595 Main St, Manchester, CT 06040 Phone: 860-646-1000 Fax: 860-645-1120 | |
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Ali Shakibai, Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 945 Main St, Suite 205, Manchester, CT 06040 Phone: 860-649-8074 Fax: 860-647-1129 | |
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