Organization
VA HEALTH CARE SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TROY GENE MICHIE SR. (LPN)
(203) 927-4242
Entity
Organization
Contact information
Practice address
421 N MAIN ST, LEEDS, MA 01053-9764
(413) 582-3146
Mailing address
19 TALMADGE HILL RD, PROSPECT, CT 06712-1724
(203) 758-4154
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
029733
CT
Other
Enumeration date
12/08/2012
Last updated
12/08/2012
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