Organization
CONCRETE INTERVENTIONS AND SUPPORT SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA ROSE LCSW (OWNER)
(860) 995-7155
Entity
Organization
Contact information
Practice address
55 GREAT MEADOW LN, AVON, CT 06001-4549
(860) 995-7155
Mailing address
55 GREAT MEADOW LN, AVON, CT 06001-4549
(860) 995-7155
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/06/2021
Last updated
12/06/2021
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