Organization
PORTERS HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA WRENN LCSW (CLINICAL THERAPIST)
(203) 519-2222
Entity
Organization
Contact information
Practice address
159 EDGEWOOD AVE, WATERBURY, CT 06706-2211
(203) 519-2222
Mailing address
159 EDGEWOOD AVE, WATERBURY, CT 06706-2211
(203) 519-2222
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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