Provider Demographics
NPI:1184927659
Name:THE LEARNING CLINIC, INC.
Entity type:Organization
Organization Name:THE LEARNING CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:W
Authorized Official - Last Name:DUCHARME
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-774-5619
Mailing Address - Street 1:PO BOX 324
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:CT
Mailing Address - Zip Code:06234-0324
Mailing Address - Country:US
Mailing Address - Phone:860-774-5619
Mailing Address - Fax:860-774-1037
Practice Address - Street 1:476 POMFRET RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:CT
Practice Address - Zip Code:06234-1526
Practice Address - Country:US
Practice Address - Phone:860-774-5619
Practice Address - Fax:860-774-1037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children