| Cleanslate Medical Group Of Connecticut Llc | |
|
85 Gillett St Hartford CT 06105-2630 | |
| (615) 425-0220 | |
| (413) 727-3619 |
| Full Name | Cleanslate Medical Group Of Connecticut Llc |
|---|---|
| Speciality | Internal Medicine - Addiction Medicine |
| Location | 85 Gillett St, Hartford, Connecticut |
| Authorized Official Name and Position | Robert Hutchison (CFO) |
| Authorized Official Contact | 6154250220 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cleanslate Medical Group Of Connecticut Llc 8 Cadillac Dr Ste 180 Brentwood TN 37027-5393 Ph: (615) 425-0220 | Cleanslate Medical Group Of Connecticut Llc 85 Gillett St Hartford CT 06105-2630 Ph: (615) 425-0220 |
| NPI Number | 1073057071 |
|---|---|
| Provider Enumeration Date | 12/09/2016 |
| Last Update Date | 03/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073057071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Primary |
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