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General NPI Number Information
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NPI Number | 1871845586
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Entity Type | Organization
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Legal Business Name | THE HEALING TREE, LLC
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 20 PENDLETON DR
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City | HEBRON
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State | CT
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Zip | 06248-1525
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Country | US
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Telephone | 860-377-4064
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Fax |
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Provider Business Mailing Address
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Address Line | 20 PENDLETON DR
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City | HEBRON
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State | CT
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Zip | 06248-1525
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PATTI C DUNNE
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Credential |
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Telephone | 860-977-4064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 001845
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License Number State | CT
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