Porters House
Clinic/Center, Mental Health (Including Community Mental Health Center) in Waterbury, CT. Organization (NPI-2).
NPI number1669940599
StatusActive
Last updated in NPPESNov 8, 2018
Details
- NPI
- 1669940599
- Entity type
- Organization (NPI-2)
- Legal business name
- Porters House
- Organization subpart
- No
- Enumeration date
- Nov 8, 2018
- Last updated
- Nov 8, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
159 Edgewood AveWaterbury, CT 06706-2211
Phone 203-519-2222
Mailing address
159 Edgewood AveWaterbury, CT 06706-2211
Phone 203-519-2222
Authorized official
Sara Wrenn
Clinical Therapist
2035192222
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