| Ketamine Center Llc | |
|
232 Boston Post Rd Ste 13 Milford CT 06460-3158 | |
| (203) 701-6388 | |
| (203) 306-3134 |
| Full Name | Ketamine Center Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 232 Boston Post Rd Ste 13, Milford, Connecticut |
| Authorized Official Name and Position | Al Gene Ejusa Ang (OFFICE MANAGER) |
| Authorized Official Contact | 8605527592 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ketamine Center Llc 232 Boston Post Rd Ste 13 Milford CT 06460-3158 Ph: (203) 701-6388 | Ketamine Center Llc 232 Boston Post Rd Ste 13 Milford CT 06460-3158 Ph: (203) 701-6388 |
| NPI Number | 1720866916 |
|---|---|
| Provider Enumeration Date | 09/19/2023 |
| Last Update Date | 11/30/2023 |
| Certification Date | 11/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720866916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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