MEDICARE: ANOINTED BEHAVIORAL HEALTH 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1932939477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANOINTED BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	196 MORNINGSIDE ST W
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06112-1031
Country	:	US
Telephone Number	:	860-804-1646
Fax Number	:

Provider Business Practice Location Address
First Line	:	304 W MAIN ST STE 2-1157
Second Line	:
City	:	AVON
State	:	CT
Zip	:	06001-4355
Country	:	US
Telephone Number	:	860-804-1646
Fax Number	:

Authorized Official
Title or Position	:	OWNER / PROVIDER
Name	:	MR. MILTON JASON BROWN
Credential	:	APRN
Telephone Number	:	860-804-1646

Provider Enumeration Date	:	08/07/2024
Last Update Date	:	08/07/2024

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