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General NPI Number Information
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NPI Number | 1609464361
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Entity Type | Organization
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Legal Business Name | THE ANCHORED GROUP LLC
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Dates
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Enumeration Date | 01/07/2021
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 23 CARTER DR
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City | MILFORD
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State | CT
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Zip | 06460-5604
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Country | US
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Telephone | 203-815-9546
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Fax |
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Provider Business Mailing Address
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Address Line | 23 CARTER DR
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City | MILFORD
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State | CT
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Zip | 06460-5604
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Country | US
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Telephone | 203-815-9546
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | MR. DERRICK D LEWIS
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Credential | REV.
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Telephone | 203-815-9546
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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