Provider Demographics
NPI:1750158234
Name:CONSOLIDATED HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:CONSOLIDATED HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:860-946-3395
Mailing Address - Street 1:32 PARTRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:CT
Mailing Address - Zip Code:06754-1726
Mailing Address - Country:US
Mailing Address - Phone:860-946-3395
Mailing Address - Fax:
Practice Address - Street 1:168 S MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-6448
Practice Address - Country:US
Practice Address - Phone:609-700-0788
Practice Address - Fax:860-970-0393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care