Healthcare Provider Details

I. General information

NPI: 1972029643
Provider Name (Legal Business Name): THE CONNECTION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WATER ST
NORWICH CT
06360-5730
US

IV. Provider business mailing address

100 ROSCOMMON DR STE 203
MIDDLETOWN CT
06457-7558
US

V. Phone/Fax

Practice location:
  • Phone: 860-425-5258
  • Fax:
Mailing address:
  • Phone: 860-343-5500
  • Fax: 844-640-2806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number0627
License Number StateCT

VIII. Authorized Official

Name: SARAH JONES
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 860-343-5500