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General NPI Number Information
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NPI Number | 1023383064
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Entity Type | Organization
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Legal Business Name | FAMILY AND CHILDREN'S AID
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 75 WEST ST
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City | DANBURY
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State | CT
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Zip | 06810-6528
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Country | US
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Telephone | 860-387-8256
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Fax | 860-482-6153
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Provider Business Mailing Address
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Address Line | 75 WEST ST
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City | DANBURY
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State | CT
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Zip | 06810-6528
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Country | US
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Telephone | 860-387-8256
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Fax | 860-482-6153
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | IRVIN JENNINGS
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Credential | M.D.
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Telephone | 860-866-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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