Organization
HARTFORD GAY & LESBIAN HEALTH COLLECTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA M. ESTABROOK MPH (EXECUTIVE DIRECTOR)
(860) 278-4163
Entity
Organization
Contact information
Practice address
1841 BROAD ST, HARTFORD, CT 06114-1780
(860) 278-4163
(860) 278-5995
Mailing address
1841 BROAD ST., HARTFORD, CT 06114-2094
(860) 278-4163
(860) 278-5995
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
001588
CT
122300000X
Dentist
Primary
007780
CT
124Q00000X
Dental Hygienist
002904
CT
163W00000X
Registered Nurse
R49289
CT
171100000X
Acupuncturist
000166
CT
207RI0200X
Infectious Disease Physician
031112
CT
261Q00000X
Clinic/Center
0302
CT
Other
Enumeration date
04/26/2011
Last updated
11/10/2015
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