Organization
FAMILYWISE, LLC
Active
Other names
FamilyWise Behavior Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA W WEST M.A., BCBA (OWNER)
(860) 642-7379
Entity
Organization
Contact information
Practice address
4 BROADWAY AVENUE EXT, 2C, MYSTIC, CT 06355-2850
(860) 642-7379
Mailing address
PO BOX 26, MYSTIC, CT 06355-0026
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204714
—
CT
Enumeration date
08/16/2016
Last updated
08/16/2016
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