Organization
COMMUNITY CHILD GUIDANCE CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLIFFORD JOHNSON LCSW (EXECUTIVE DIRECTOR)
(860) 643-2101
Entity
Organization
Contact information
Practice address
317 N MAIN ST, MANCHESTER, CT 06042-2007
(860) 643-2101
(860) 645-1470
Mailing address
317 N MAIN ST, MANCHESTER, CT 06042-2007
(860) 643-2101
(860) 645-1470
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
0238
CT
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
OPCC-14
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004039277
—
CT
Enumeration date
01/26/2007
Last updated
05/03/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us