Provider Demographics
NPI:1033527312
Name:LOUIS GRAFF LLC
Entity Type:Organization
Organization Name:LOUIS GRAFF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:FOROUHAR-GRAFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-748-7773
Mailing Address - Street 1:68 S MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2445
Mailing Address - Country:US
Mailing Address - Phone:860-748-7773
Mailing Address - Fax:860-561-6184
Practice Address - Street 1:68 S MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2445
Practice Address - Country:US
Practice Address - Phone:860-748-7773
Practice Address - Fax:860-561-6184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT051198261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health