Organization
BRAVELY CONNECTED P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENESIS CAMPOS (LICENSED CLINICAL SOCIAL WORKER)
(860) 335-8765
Entity
Organization
Contact information
Practice address
71 RAYMOND RD STE 105A, WEST HARTFORD, CT 06107-2211
(860) 335-8765
Mailing address
71 RAYMOND RD STE 105A, WEST HARTFORD, CT 06107-2211
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
07/14/2021
Last updated
07/14/2021
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