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Organization
HOSPITAL OF SAINT RAPHAEL
Active
Organization
HOSPITAL OF SAINT RAPHAEL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER BALLEW D.O (MEDICAL DIRECTOR)
(203) 784-8750
Entity
Organization
Contact information
Practice address
1294 CHAPEL ST, 2ND FLOOR, NEW HAVEN, CT 06511-4515
(203) 784-8750
Mailing address
1294 CHAPEL ST, 2ND FLOOR, NEW HAVEN, CT 06511-4515
(203) 784-8750
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
06/22/2012
Last updated
06/22/2012
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