Healthcare Provider Details

I. General information

NPI: 1891050092
Provider Name (Legal Business Name): APADOS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 07/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DUNBAR DR
WINDSOR CT
06095-4767
US

IV. Provider business mailing address

1 DUNBAR DR
WINDSOR CT
06095-4767
US

V. Phone/Fax

Practice location:
  • Phone: 860-593-8483
  • Fax: 860-371-2602
Mailing address:
  • Phone: 860-593-8483
  • Fax: 860-371-2602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. REGINA V ROUNDTREE
Title or Position: CEO
Credential:
Phone: 860-593-8483