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General NPI Number Information
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NPI Number | 1174056659
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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 | 04/11/2017
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 52 MAIN ST
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City | NEW BRITAIN
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State | CT
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Zip | 06051-2509
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Country | US
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Telephone | 203-747-2851
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Fax |
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Provider Business Mailing Address
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Address Line | 52 MAIN STREET
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City | NEW BRITAIN
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State | CT
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Zip | 06051
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Country | US
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Telephone | 203-747-2851
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | MS. LINDSAY S PENEV
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Credential | LMSW
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Telephone | 203-747-2851
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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 | 001124
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License Number State | CT
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