Organization · NPI-2

Boys And Girls Village, , INC.

Community/Behavioral Health · Bridgeport, CT

NPI number1801250956
StatusActive
Last updated in NPPESApr 5, 2016

Details

NPI
1801250956
Entity type
Organization (NPI-2)
Legal business name
Boys And Girls Village, , INC.
Organization subpart
No
Enumeration date
Apr 5, 2016
Last updated
Apr 5, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health––Yes

Practice location

170 Bennett St
Bridgeport, CT 06605-2901

Phone 203-330-6790 · Fax 203-330-6756

Mailing address

170 Bennett St
Bridgeport, CT 06605-2901

Phone 203-330-6790 · Fax 203-330-6756

Authorized official

Tasha Yearwood
Iicaps Clinician
2036905128

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