Organization Name: | OLD SAYBROOK YOUTH AND FAMILY SERVICES |
NPI Number: | 1164699914 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LARRY FREUNDLICH (DIRECTOR) |
Mailing Address: | 322 Main St Old Saybrook |
State: | CT US |
Postal Code: | 064752350 |
Phone Number: | 8603953190 |
Fax Number: | |
NPI Enumeration Date: | 05/12/2008 |
NPI Last Update Date: | 05/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 003682 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |