Healthcare Provider Details

I. General information

NPI: 1063413011
Provider Name (Legal Business Name): UNITED SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 N MAIN ST
DAYVILLE CT
06241-2123
US

IV. Provider business mailing address

1007 N MAIN ST
DAYVILLE CT
06241-2170
US

V. Phone/Fax

Practice location:
  • Phone: 860-774-2020
  • Fax: 860-774-0826
Mailing address:
  • Phone: 860-774-2020
  • Fax: 860-774-0826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberCPA-39
License Number StateCT

VIII. Authorized Official

Name: MS. DIANE L MANNING
Title or Position: PRESIDENT/CEO
Credential: MBA CBHE
Phone: 860-774-2020