Organization
WRH MENTAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM RAYMOND HENDRIXSON APRN (OWNER)
(203) 315-8012
Entity
Organization
Contact information
Practice address
141 N MAIN ST, BRANFORD, CT 06405-3018
(203) 315-8012
(203) 315-8013
Mailing address
141 N MAIN ST, BRANFORD, CT 06405-3018
(203) 315-8012
(203) 315-8013
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
001669
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
001669
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004188711
—
CT
01
—
1255383915
INDV NPI
CT
01
—
1972788271
GROUP NPI
CT
01
—
C03838
GROUP PIN
CT
Enumeration date
01/04/2008
Last updated
11/30/2012
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