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General NPI Number Information
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NPI Number | 1548353832
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Entity Type | Organization
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Legal Business Name | POSITIVE ALTERNATIVES FOR CHILDREN & TEENS, INC
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Dates
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Enumeration Date | 10/01/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 391 BROAD ST 2ND FLOOR
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City | MERIDEN
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State | CT
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Zip | 06450-5844
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Country | US
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Telephone | 203-634-6095
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Fax |
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Provider Business Mailing Address
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Address Line | 85 LEXINGTON ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1416
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Country | US
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Telephone | 860-223-1111
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. HAROLD FISCHER
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Credential | LCSW
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Telephone | 203-634-6095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 002538
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License Number State | CT
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