Organization
BEACON
Active
Organization
BEACON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE CLARK (OFFICE MANAGER)
(508) 473-8338
Entity
Organization
Contact information
Practice address
160 WEST ST, SUITE G, CROMWELL, CT 06416-2441
(860) 613-9930
Mailing address
160 WEST ST, SUITE G, CROMWELL, CT 06416-2441
(860) 613-9930
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1052232
CT
Other
Enumeration date
08/02/2012
Last updated
08/02/2012
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