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General NPI Number Information
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NPI Number | 1033359500
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Entity Type | Organization
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Legal Business Name | EXCHANGE CLUB CENTER FOR THE PREVENTION OF CHILD ABUSE OF CT, INC.
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Dates
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Enumeration Date | 02/24/2009
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Last Update Date | 02/24/2009
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Provider Practice Location Address
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Address Line | 19 ELM ST
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City | VERNON ROCKVILLE
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State | CT
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Zip | 06066-3207
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Country | US
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Telephone | 860-872-1918
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Fax | 860-872-8066
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Provider Business Mailing Address
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Address Line | 19 ELM ST
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City | VERNON ROCKVILLE
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State | CT
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Zip | 06066-3207
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Country | US
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Telephone | 860-872-1918
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Fax | 860-872-8066
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ANGELA F ATWATER
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Credential | M.A.
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Telephone | 860-872-1918
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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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