Healthcare Provider Details

I. General information

NPI: 1285852624
Provider Name (Legal Business Name): UNITED COMMUNITY AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 CHICAGO AVE
GROTON CT
06340-4907
US

IV. Provider business mailing address

47 TOWN ST
NORWICH CT
06360-2315
US

V. Phone/Fax

Practice location:
  • Phone: 860-892-7042
  • Fax: 860-892-7043
Mailing address:
  • Phone: 860-892-7042
  • Fax: 860-892-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberC-0280
License Number StateCT

VIII. Authorized Official

Name: JOANNE SMART
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 860-822-4153