MEDICARE: THE LAAM INC

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	251S00000X	Community/Behavioral Health Agency	000786	CT
2	251S00000X	Community/Behavioral Health Agency	001780	CT

General Provider Information

NPI Number	:	1770721011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE LAAM INC

Provider Business Mailing Address
First Line	:	1115 MAIN ST STE 309
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06604-4415
Country	:	US
Telephone Number	:	203-334-5500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 MAIN ST STE 309
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06604-4415
Country	:	US
Telephone Number	:	203-334-5500
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KATHERINE FRANCES MUSE-MCGEE
Credential	:	L.A.D.C, L.P.C
Telephone Number	:	203-334-5500

Provider Enumeration Date	:	01/23/2009
Last Update Date	:	01/23/2009

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Directions to “THE LAAM INC ” Practice Location

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