Provider Demographics
NPI:1669466355
Name:NEW ENGLAND CENTER FOR NATURAL BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:NEW ENGLAND CENTER FOR NATURAL BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:FERACO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-922-4280
Mailing Address - Street 1:PO BOX 223
Mailing Address - Street 2:
Mailing Address - City:OLD MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06372-0223
Mailing Address - Country:US
Mailing Address - Phone:860-922-4280
Mailing Address - Fax:
Practice Address - Street 1:44 WASHINGTON ST
Practice Address - Street 2:SUITES 213-214
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2839
Practice Address - Country:US
Practice Address - Phone:860-922-4280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)