Healthcare Provider Details

I. General information

NPI: 1861634073
Provider Name (Legal Business Name): B-HEALTHY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 TOBEY RD OFC 2
BLOOMFIELD CT
06002-3521
US

IV. Provider business mailing address

PO BOX 2466
HARTFORD CT
06146-2466
US

V. Phone/Fax

Practice location:
  • Phone: 860-770-3208
  • Fax: 866-734-8280
Mailing address:
  • Phone: 860-770-3208
  • Fax: 866-734-8280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHCA.0000678
License Number StateCT
# 6
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MS. IVETTE CORTES
Title or Position: MANAGER/OWNER
Credential: MBA
Phone: 860-770-3208