Organization
TOWN OF STAFFORD
Active
Other names
Stafford Family Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDY GARDNER LMFT (EXECUTIVE DIRECTOR)
(860) 684-4239
Entity
Organization
Contact information
Practice address
21 HYDE PARK RD, STAFFORD SPRINGS, CT 06076-1507
(860) 684-4239
(860) 684-0511
Mailing address
21 HYDE PARK ROAD, STAFFORD SPRINGS, CT 06076-1507
(860) 684-4239
(860) 684-0511
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
0605
CT
251S00000X
Community/Behavioral Health Agency
Primary
OPCC 77
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008032687
—
CT
Enumeration date
02/04/2016
Last updated
02/04/2016
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