Organization
MODERN BEHAVIORAL & MENTAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUCHI NWOKOCHA (OWNER)
(612) 481-7636
Entity
Organization
Contact information
Practice address
116 COTTAGE GROVE RD STE 110, BLOOMFIELD, CT 06002-3200
(612) 481-7636
Mailing address
2389 MAIN ST STE 100, GLASTONBURY, CT 06033-4617
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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