| Growing Potential Services:therapeutic And Behavioral Solutions, Pc | |
|
25 High St Enfield CT 06082 | |
| (606) 986-0778 | |
| (860) 698-6631 |
| Full Name | Growing Potential Services:therapeutic And Behavioral Solutions, Pc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 25 High St, Enfield, Connecticut |
| Authorized Official Name and Position | Marcy Taliceo (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8606986077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Growing Potential Services:therapeutic And Behavioral Solutions, Pc 25 High St Enfield CT 06082-3410 Ph: (860) 698-6077 | Growing Potential Services:therapeutic And Behavioral Solutions, Pc 25 High St Enfield CT 06082 Ph: (606) 986-0778 |
| NPI Number | 1336588607 |
|---|---|
| Provider Enumeration Date | 06/20/2013 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336588607 | NPI | - | NPPES |
| 008045179 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 8146 (Massachusetts) | Secondary |
| 251S00000X | Community/behavioral Health | 2378 (Connecticut) | Primary |
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