Camellia Place Healthcare Services LLC
Clinic/Center, Primary Care in Newington, CT. Organization (NPI-2).
NPI number1447812250
StatusActive
Last updated in NPPESSep 6, 2019
Details
- NPI
- 1447812250
- Entity type
- Organization (NPI-2)
- Legal business name
- Camellia Place Healthcare Services LLC
- Organization subpart
- No
- Enumeration date
- Jul 1, 2019
- Last updated
- Sep 6, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – | |
| 363LP2300X | Nurse Practitioner, Primary Care | – | – |
Practice location
100 Market Sq Ste 12Newington, CT 06111-2921
Phone 860-322-1011
Mailing address
24 Sachem CirMeriden, CT 06450-7403
Phone 203-715-1319
Authorized official
Camille A Payne
Nurse Practitioner
8603221011
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