Organization
JCCA
Active
Other names
jcca
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MCDONALD (RESIDENTIAL YOUTH COUNSELOR)
(443) 983-5359
Entity
Organization
Contact information
Practice address
545 BEDFORD ST, STAMFORD, CT 06901-1526
(443) 983-5359
Mailing address
545 BEDFORD ST APT 407, STAMFORD, CT 06901-1528
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/30/2024
Last updated
04/30/2024
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