Organization
REDEEM WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE CULLEN (MEDICAL BILLING MANAGER)
(203) 368-5515
Entity
Organization
Contact information
Practice address
3180 MAIN ST STE 106, BRIDGEPORT, CT 06606-4237
(203) 208-3940
(203) 372-3272
Mailing address
6405 CAMDEN RD, FAYETTEVILLE, NC 28306-7216
(910) 275-5766
(833) 596-0382
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004069985
—
CT
Enumeration date
08/14/2019
Last updated
09/22/2020
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