Organization
WBC CONNECTICUT EAST, LLC
Active
Parent organization
WALDEN BEHAVIORAL CARE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALDEN BEHAVIORAL CARE, LLC
Authorized official
DR. STUART KOMAN PHD (CEO / OWNER)
(781) 647-6701
Entity
Organization
Contact information
Practice address
2400 TAMARACK AVE, SUITE 203, SOUTH WINDSOR, CT 06074-5555
(860) 533-4672
(860) 533-4673
Mailing address
880 MAIN ST, WALTHAM, MA 02451-8500
(781) 647-6767
(781) 647-6755
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
06/20/2012
Last updated
10/04/2012
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