Provider Demographics
NPI:1891840021
Name:KLINGBERG COMPREHENSIVE FAMILY SERVICES INC
Entity Type:Organization
Organization Name:KLINGBERG COMPREHENSIVE FAMILY SERVICES INC
Other - Org Name:KLINGBERG FAMILY CENTERS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-832-5501
Mailing Address - Street 1:120 HOLCOMB STREET
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06112
Mailing Address - Country:US
Mailing Address - Phone:860-243-4416
Mailing Address - Fax:860-286-3049
Practice Address - Street 1:120 HOLCOMB STREET
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112
Practice Address - Country:US
Practice Address - Phone:860-243-4416
Practice Address - Fax:860-286-3049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTOPCC45251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health