Organization
ACTSINC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD GONZALEZ LADC (CLINICIAN)
(516) 652-2100
Entity
Organization
Contact information
Practice address
151 NEW PARK AVE, SUITE 120, HARTFORD, CT 06106-2170
(516) 652-2100
Mailing address
151 NEW PARK AVE, SUITE 120, HARTFORD, CT 06106-2170
(516) 652-2100
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
1090
CT
Other
Enumeration date
10/21/2015
Last updated
11/09/2015
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