| Boys And Girls Village | |
|
170 Bennett St Bridgeport CT 06605-2901 | |
| (203) 980-4625 | |
| Not Available |
| Full Name | Boys And Girls Village |
|---|---|
| Speciality | Social Worker |
| Location | 170 Bennett St, Bridgeport, Connecticut |
| Authorized Official Name and Position | Krista Amato (IICAPS CLINICIAN) |
| Authorized Official Contact | 2039804625 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boys And Girls Village 170 Bennett St Bridgeport CT 06605-2901 Ph: () - | Boys And Girls Village 170 Bennett St Bridgeport CT 06605-2901 Ph: (203) 980-4625 |
| NPI Number | 1154853307 |
|---|---|
| Provider Enumeration Date | 03/28/2017 |
| Last Update Date | 03/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154853307 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 10762370 (Connecticut) | Primary |
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