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NPI Code Detail

MEDICARE: AVIV THERAPEUTIC SERVICES LLC

MEDICARE: AVIV THERAPEUTIC SERVICES LLC
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
1251S00000XCommunity/Behavioral Health Agency003327CT

General Provider Information

NPI Number : 1871038596
Entity Type Code : Organization
Provider Name (Legal Business Name) : AVIV THERAPEUTIC SERVICES LLC
Provider Business Mailing Address
First Line : PO BOX 123
Second Line :
City : BOTSFORD
State : CT
Zip : 06404-0123
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 450 MONROE TPKE
Second Line : SUITE 105
City : MONROE
State : CT
Zip : 06468-2343
Country : US
Telephone Number : 203-733-1129
Fax Number :
Authorized Official
Title or Position : OWNER CLINICIAN
Name : AMY DAVIDA SINGER
Credential : LCSW
Telephone Number : 203-426-6829
Provider Enumeration Date : 01/04/2017
Last Update Date : 01/04/2017

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Directions to “AVIV THERAPEUTIC SERVICES LLC ” Practice Location

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