Healthcare Provider Details

I. General information

NPI: 1134598543
Provider Name (Legal Business Name): FAMILY AND CHILDREN'S AID
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 WEST ST
DANBURY CT
06810-6528
US

IV. Provider business mailing address

75 WEST ST
DANBURY CT
06810-6528
US

V. Phone/Fax

Practice location:
  • Phone: 203-748-5689
  • Fax:
Mailing address:
  • Phone: 203-748-5689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number6236
License Number StateCT

VIII. Authorized Official

Name: MISS CAROL ANNE SPECTER
Title or Position: APRN
Credential:
Phone: 617-849-3885