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General NPI Number Information
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NPI Number | 1831375062
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Entity Type | Organization
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Legal Business Name | CIRCLE OF LIFE TRANSITION CENTER, LLC
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 1 CONGRESS ST SUITE 207
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City | HARTFORD
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State | CT
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Zip | 06114-1067
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Country | US
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Telephone | 860-293-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CONGRESS ST SUITE 207
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City | HARTFORD
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State | CT
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Zip | 06114-1067
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Country | US
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Telephone | 860-293-1000
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/CLINICIAN
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Name | VALARIE L WILLIAMS
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Credential | LPC
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Telephone | 860-293-1000
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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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