Healthcare Provider Details

I. General information

NPI: 1487765228
Provider Name (Legal Business Name): NEW ENGLAND HOLISTIC HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 SYCAMORE ST
GLASTONBURY CT
06033-2223
US

IV. Provider business mailing address

155 SYCAMORE ST
GLASTONBURY CT
06033-2223
US

V. Phone/Fax

Practice location:
  • Phone: 860-659-3553
  • Fax: 860-659-0744
Mailing address:
  • Phone: 860-659-3553
  • Fax: 860-659-0744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberCT000140
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberCT027887
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCT000486
License Number StateCT

VIII. Authorized Official

Name: EVA FRANCIS SALZER
Title or Position: CO-DIRECTOR
Credential: DC
Phone: 860-659-3553