| We-mpact Llc | |
|
258 Middle St Suite C Bristol CT 06010-7492 | |
| (860) 940-4838 | |
| Not Available |
| Full Name | We-mpact Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 258 Middle St, Bristol, Connecticut |
| Authorized Official Name and Position | Bette J Kozak (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8609404838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| We-mpact Llc 258 Middle St Suite C Bristol CT 06010-7492 Ph: (860) 940-4838 | We-mpact Llc 258 Middle St Suite C Bristol CT 06010-7492 Ph: (860) 940-4838 |
| NPI Number | 1871819631 |
|---|---|
| Provider Enumeration Date | 04/19/2010 |
| Last Update Date | 04/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871819631 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 000562 (Connecticut) | Secondary |
| 251S00000X | Community/behavioral Health | 000562 (Connecticut) | Primary |
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