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General NPI Number Information
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NPI Number | 1619768165
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Entity Type | Organization
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Legal Business Name | TRINITY WELLNESS OF CT LLC
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 350 CENTER ROCK GRN STE 3
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City | OXFORD
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State | CT
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Zip | 06478-3170
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Country | US
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Telephone | 203-870-1796
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Fax | 203-307-1771
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Provider Business Mailing Address
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Address Line | 350 CENTER ROCK GRN STE 3
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City | OXFORD
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State | CT
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Zip | 06478-3170
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Country | US
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Telephone | 203-870-1796
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Fax | 203-307-1771
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Authorized Official
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Title or Position | PARTNER
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Name | DAISY FONTAN
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Credential |
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Telephone | 203-870-1796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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