| Hospital Of Saint Raphael | |
|
1294 Chapel St 2nd Floor New Haven CT 06511-4515 | |
| (203) 784-8750 | |
| Not Available |
| Full Name | Hospital Of Saint Raphael |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1294 Chapel St, New Haven, Connecticut |
| Authorized Official Name and Position | Jennifer Ballew (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2037848750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hospital Of Saint Raphael 1294 Chapel St 2nd Floor New Haven CT 06511-4515 Ph: (203) 784-8750 | Hospital Of Saint Raphael 1294 Chapel St 2nd Floor New Haven CT 06511-4515 Ph: (203) 784-8750 |
| NPI Number | 1023371275 |
|---|---|
| Provider Enumeration Date | 06/22/2012 |
| Last Update Date | 06/22/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023371275 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
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