Provider Demographics
NPI:1821345240
Name:LUTHERAN COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:LUTHERAN COMMUNITY SERVICES, INC.
Other - Org Name:LUTHERAN ADOPTION SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT FOR OPERATIONS, CT
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:FORBES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-347-7144
Mailing Address - Street 1:2139 SILAS DEANE HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2336
Mailing Address - Country:US
Mailing Address - Phone:860-257-9899
Mailing Address - Fax:860-257-0340
Practice Address - Street 1:2139 SILAS DEANE HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2336
Practice Address - Country:US
Practice Address - Phone:860-257-9899
Practice Address - Fax:860-257-0340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001200106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty