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General NPI Number Information
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NPI Number | 1518261999
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Entity Type | Organization
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Legal Business Name | KLINGBERG COMPREHENSIVE FAMILY SERVICES, INC.
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Dates
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Enumeration Date | 12/29/2010
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Last Update Date | 12/29/2010
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Provider Practice Location Address
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Address Line | 370 LINWOOD ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1949
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Country | US
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Telephone | 860-832-5575
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Fax |
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Provider Business Mailing Address
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Address Line | 157 CHARTER OAK AVE
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City | HARTFORD
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State | CT
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Zip | 06106-1913
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Country | US
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Telephone | 860-243-4416
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Fax | 860-243-4418
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Authorized Official
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Title or Position | VICE PRESIDENT OF COMMUNITY SERVICE
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Name | MR. DAVID LAWRENCE-HAWWLEY
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Credential | MSW
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Telephone | 860-243-4416
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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 | EDT-9
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License Number State | CT
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