NPI 1881992626

Correctional Manageed Health Care

Organisation Exclusive Provider Organization Suffield, CT

Practice location

Address: 1153 East St S, Suffield, CT 06080-0001
Phone: (860) 627-2271
Fax: (860) 627-2265

Authorised official

Name: Joseph C Coleman
Title: Supervising Psychologist
Phone: (860) 627-2271

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 002217 (CT)

Other Exclusive Provider Organization providers in Connecticut →

Registry record

NPI: 1881992626
Entity type: Organization
NPI issued: 3 Mar 2011
Record last updated: 3 Mar 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.