Provider Demographics
NPI:1821490004
Name:YOUR FAMILY HEALTH SOLUTIONS LLC
Entity Type:Organization
Organization Name:YOUR FAMILY HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:860-268-3439
Mailing Address - Street 1:520 HARTFORD TPKE
Mailing Address - Street 2:BUILDING B, SUITE V
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-5037
Mailing Address - Country:US
Mailing Address - Phone:860-875-3030
Mailing Address - Fax:
Practice Address - Street 1:520 HARTFORD TPKE
Practice Address - Street 2:BUILDING B, SUITE V
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-5037
Practice Address - Country:US
Practice Address - Phone:860-875-3030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care