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General NPI Number Information
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NPI Number | 1003190950
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Entity Type | Organization
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Legal Business Name | NATCHAUG HOSPITAL
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Dates
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Enumeration Date | 10/10/2011
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Last Update Date | 10/10/2011
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Provider Practice Location Address
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Address Line | 428 HARTFORD TPKE SUITE 105
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City | VERNON
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State | CT
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Zip | 06066-4841
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Country | US
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Telephone | 860-870-0119
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Fax | 860-870-0122
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Provider Business Mailing Address
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Address Line | 189 STORRS RD
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City | MANSFIELD CENTER
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State | CT
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Zip | 06250-1683
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. PAUL MALONEY
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Credential |
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Telephone | 860-456-1311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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