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General NPI Number Information
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NPI Number | 1487689022
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Entity Type | Organization
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Legal Business Name | STATE OF CONNECTICUT
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 500 VINE STREET
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City | HARTFORD
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State | CT
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Zip | 06112
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Country | US
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Telephone | 860-297-0975
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Fax | 860-297-0914
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Provider Business Mailing Address
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Address Line | 500 VINE STREET
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City | HARTFORD
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State | CT
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Zip | 06112
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Country | US
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Telephone | 860-297-0975
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Fax | 860-297-0914
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Authorized Official
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Title or Position | DIRECTOR OF HEALTH CARE FINANCE
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Name | CHRISTINA ARIAS
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Credential |
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Telephone | 860-418-6800
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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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