Organization
CHILDREN OF THE WILDERNESS OUTREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL R LEWIS-TILLMAN (CO FOUNDER)
(203) 628-8096
Entity
Organization
Contact information
Practice address
71 NORFOLK STREET, WEST HAVEN, CT 06516
(203) 479-5821
(203) 931-8535
Mailing address
71 NORFOLK ST, WEST HAVEN, CT 06516-2528
(203) 628-8096
(203) 931-8535
Taxonomy
Speciality
Code
Description
License number
State
282J00000X
Religious Nonmedical Health Care Institution
Primary
501C3
CT
Other
Enumeration date
03/17/2008
Last updated
10/22/2009
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