Organization · NPI-2

Child Guidance Center Of Greater Bpt

Community/Behavioral Health · Bridgeport, CT

NPI number1902139181
StatusActive
Last updated in NPPESSep 7, 2009

Details

NPI
1902139181
Entity type
Organization (NPI-2)
Legal business name
Child Guidance Center Of Greater Bpt
Organization subpart
No
Enumeration date
Sep 7, 2009
Last updated
Sep 7, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health––Yes

Practice location

180 Fairfield Ave
Bridgeport, CT 06604-4252

Phone 203-394-6529

Mailing address

180 Fairfield Ave
Bridgeport, CT 06604-4252

Phone 203-394-6529

Authorized official

Jeanne Marion Odonnell
Supervisor
2032552631

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