MEDICARE: SANA2 COLITA ADULT BEHAVIORAL HEALTH RX. TREATMENT & WELLNESS REFUGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1447072988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANA2 COLITA ADULT BEHAVIORAL HEALTH RX. TREATMENT & WELLNESS REFUGE

Provider Business Mailing Address
First Line	:	378 WINDSOR AVE
Second Line	:
City	:	WINDSOR
State	:	CT
Zip	:	06095-4551
Country	:	US
Telephone Number	:	860-219-2095
Fax Number	:

Provider Business Practice Location Address
First Line	:	378 WINDSOR AVE
Second Line	:
City	:	WINDSOR
State	:	CT
Zip	:	06095-4551
Country	:	US
Telephone Number	:	860-219-2095
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MS. MARIA RUIZ
Credential	:	APRN
Telephone Number	:	860-219-2095

Provider Enumeration Date	:	10/28/2024
Last Update Date	:	03/18/2026

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