Healthcare Provider Details

I. General information

NPI: 1821490004
Provider Name (Legal Business Name): YOUR FAMILY HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 11/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 HARTFORD TPKE BUILDING B, SUITE V
VERNON CT
06066-5037
US

IV. Provider business mailing address

520 HARTFORD TPKE BUILDING B, SUITE V
VERNON CT
06066-5037
US

V. Phone/Fax

Practice location:
  • Phone: 860-875-3030
  • Fax:
Mailing address:
  • Phone: 860-875-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateCT

VIII. Authorized Official

Name: JENNIFER HOPE ROSS
Title or Position: CEO
Credential: APRN, FNP-C
Phone: 860-268-3439