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General NPI Number Information
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NPI Number | 1265672125
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Entity Type | Organization
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Legal Business Name | AIM WELL, LLC
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Dates
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Enumeration Date | 03/04/2009
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Last Update Date | 03/04/2009
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Provider Practice Location Address
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Address Line | 225 MONTOWESE ST 2ND FLOOR
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City | BRANFORD
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State | CT
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Zip | 06405-3873
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Country | US
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Telephone | 203-500-9590
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Fax |
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Provider Business Mailing Address
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Address Line | 225 MONTOWESE ST 2ND FLOOR
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City | BRANFORD
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State | CT
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Zip | 06405-3873
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Country | US
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Telephone | 203-500-9590
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Fax |
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Authorized Official
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Title or Position | OWNER, MEMBER
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Name | MS. KATHLEEN M WALSH
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Credential | APRN
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Telephone | 203-500-9590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 3150
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License Number State | CT
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