Provider Demographics
NPI:1841337284
Name:EARLY CHILDHOOD SERVICE - AMERICAN SCHOOL FOR THE DEAF
Entity type:Organization
Organization Name:EARLY CHILDHOOD SERVICE - AMERICAN SCHOOL FOR THE DEAF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-570-1816
Mailing Address - Street 1:139 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1264
Mailing Address - Country:US
Mailing Address - Phone:860-570-1881
Mailing Address - Fax:860-570-2332
Practice Address - Street 1:139 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1264
Practice Address - Country:US
Practice Address - Phone:860-570-2347
Practice Address - Fax:860-570-2332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT251C00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251C00000XAgenciesDay Training, Developmentally Disabled Services