Healthcare Provider Details

I. General information

NPI: 1245400555
Provider Name (Legal Business Name): PSYCH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 GREENWOOD ST PARK PLACE NURSING HOME
HARTFORD CT
06106-2110
US

IV. Provider business mailing address

46 POCAHONTAS DR
WEST HARTFORD CT
06117-1302
US

V. Phone/Fax

Practice location:
  • Phone: 860-236-2901
  • Fax:
Mailing address:
  • Phone: 860-462-3966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GLADYS QUINNONES
Title or Position: OWNER
Credential: APRN
Phone: 860-462-3966