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Organization
KETAMINE CENTER LLC
Active
Organization
KETAMINE CENTER LLC
Active
Other names
Ketamine Center of Connecticut
Organization subpart
No
Provider details
NPI number
Authorized official
AL GENE EJUSA ANG (OFFICE MANAGER)
(860) 552-7592
Entity
Organization
Contact information
Practice address
232 BOSTON POST RD STE 13, MILFORD, CT 06460-3158
(203) 701-6388
(203) 306-3134
Mailing address
232 BOSTON POST RD STE 13, MILFORD, CT 06460-3158
(203) 701-6388
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/19/2023
Last updated
11/30/2023
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